Medicare Gap and the NDIS Funding

I am quite often asked, can I claim the Medicare Gap, for instance if I use:

– Occupational Medicare Care Plan
– Physiotherapist Medicare Care Plan
– Speech Pathologist Medicare Care Plan
– Medicare Mental Health Plan

The answer is “NO”.

Reference the following from the NDIS.

I’ve also linked in a booklet from the NDIS which explains Medicare and NDIS in details.

A GP & Health Professional’s guide to the › media › download…/using-your-plan/self-management

Supports purchasing guide

You have choice about what supports you buy with your NDIS funding, to help you achieve your goals.

Supports must:

be linked to the support budget and goals in your current NDIS plan and related to your disability;
give you good value-for-money compared to other supports;
last the length of your plan; and
be legal.
Supports must not:

replace supports that would usually be provided by family or friends;
include supports provided by other government agencies (for example, dental, health or hospital services);
include any gap fees for Medicare; and
cause harm, or put you or others at risks.

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