If you have a chronic health condition, your GP may be able to refer you to Chiro Pro under a Chronic Disease Management plan — giving you access to Medicare-subsidised chiropractic care. You may know this by its older name, an Enhanced Primary Care plan or EPC. The name changed but the program works in much the same way, and at Chiro Pro we regularly work with patients accessing care this way. It’s one of the most underutilised healthcare benefits available.

What Is a Chronic Disease Management Plan?

A Chronic Disease Management (CDM) plan — also known as a GP Management Plan or Team Care Arrangement — is a Medicare-funded program that allows GPs to coordinate care for patients with chronic or complex health conditions. Under a CDM plan, your GP can refer you to allied health practitioners including chiropractors for Medicare-subsidised treatment.

Eligible patients can access up to 5 subsidised allied health sessions per calendar year. These sessions can be shared across different allied health providers — so if you’re already seeing a physiotherapist or podiatrist under your plan, the remaining sessions can still be used for chiropractic care at Chiro Pro.

To be eligible for a CDM plan you need to have a chronic medical condition — generally defined as one that has been present for six months or longer, or is likely to be present for that duration. Common conditions that qualify include:

• Chronic back pain or neck pain
• Arthritis and osteoarthritis
• Diabetes
• Heart disease
• Obesity
• Chronic headaches or migraines
• Neurological conditions
• Mental health conditions

Your GP is the best person to advise whether you’re eligible and whether a CDM plan is appropriate for your situation.

Medicare provides a rebate for each subsidised session under a CDM plan. There may be a gap payment depending on our current fee schedule — Chris will let you know what to expect at your first appointment. Even with a gap payment, CDM plan sessions represent a significant saving compared to the full appointment cost.

There are a few ways patients come to us under a CDM plan:

• Your GP may refer you directly to Chiro Pro as part of your management plan
• You can ask your GP for a CDM plan referral and request to be referred to Chiro Pro specifically
• Your GP may have referred you to another chiropractor, but you are welcome to bring your plan to Chiro Pro instead — the choice of provider is always yours

If you already have a CDM plan and would like to use your remaining sessions at Chiro Pro, simply bring your referral documentation to your first appointment and we’ll take it from there.

If you think you may be eligible but haven’t spoken to your GP yet, book an appointment with your GP and mention that you’d like to explore a Chronic Disease Management plan. You can request to be referred to Dr. Chris Metcalfe at Chiro Pro in Umina Beach.

If your CDM plan hasn’t been arranged yet but you’d like to get started, you are welcome to attend as a private patient and pay out of pocket. Many patients do this while their GP referral is being organised. Once your plan is in place the Medicare rebate applies from that point forward. Give us a call and we can help you work out the best approach.

Whether you already have a CDM plan or you’re not sure where to start, book online today or give us a call and we’ll help you figure out the best path forward.

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Yes — the choice of provider is always yours. Even if your GP has referred you to another chiropractor, you are entitled to take your CDM plan to any eligible provider, including Chiro Pro.

No problem. Your remaining sessions can still be used at Chiro Pro. Simply bring your referral documentation and Medicare card to your first appointment and we’ll process the rebate for the sessions you have left.

CDM plans are reviewed annually by your GP. If your condition is ongoing your GP can renew the plan each calendar year, giving you access to another 5 subsidised sessions. It’s worth booking a review appointment with your GP towards the end of each year to make sure your plan is up to date.

Yes — dry needling performed as part of a chiropractic consultation at Chiro Pro can be included in your CDM plan sessions. This makes it a particularly cost-effective way to access dry needling treatment if you have a qualifying chronic condition.