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Health Insurance and Chronic Conditions

Sally Aquire August 3rd, 2012 0 comments

Do you have a chronic or terminal illness? If so, are you aware of the Chronic Disease Management (CDM) program? If not, you could be missing out on a useful form of support. This is one of the main ways that Medicare helps those with long term health issues. Beyond that, health insurance can prove helpful for chronic conditions.

What is the CDM Program?

The CDM Program is open to those with chronic or terminal conditions. If eligible, allied health services are available. These must help you to manage your condition. There are not all that extensive – up to five may be available per calendar year.

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Who is eligible for the CDM Program?

Firstly, you must have a chronic or terminal condition. This usually needs to have been present for at least six months. You may also be eligible if the condition is thought to have been present for this time frame. Secondly, are you receiving care from more than one health professional for this condition? The eligibility criteria is not set in stone so you are best to speak to your GP to see if you qualify. He or she can prepare GP Management and Team Care Arrangements plans for you. You can then be referred to the CDM program with both of these in place.

Going beyond Medicare

Medicare rebates are limited so you may want to have private health insurance. Do you need to spend time in hospital as part of your treatment? If so, hospital cover allows private hospital treatment and choice of doctor. This is often preferable to waiting for public hospital beds to become available.

If allied health treatments prove useful for managing your condition, you can arrange extras cover to access them on a more regular basis. The usefulness of this depend on your condition but extras such as physio may help in some cases. If your condition is terminal rather than just chronic, palliative care is available as an extra.

Health management programs

Some health funds have health management programs aimed at those with chronic conditions. These will offer support from health professionals to help you to manage your health. The extent of this support will depend on the health fund. Some may offer telephone access to nurse support regarding your health condition, for example.

Which chronic conditions are covered? This varies according to the health fund. Many common chronic conditions are covered by at least one health fund though. Compare health funds to see if your chronic condition is supported somewhere.

Be aware that you may need to have a specific type of cover to access health management programs. Some health funds will require you to have hospital or combined cover, for example.

Summing things up

Medicare can give some support for chronic conditions. However, the CDM program only offers a total of five allied health sessions per calendar year. For more extensive support, you may want to compare health insurance. You may benefit from having hospital or extras cover or both. Some health funds also offer much broader support for those living with chronic conditions. This includes health management programs. It is worth taking the time to compare health insurance to see what support is open to you.

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