From 1 November 2019, some Australians experiencing eating disorders will be able to access more support through Medicare. Known as an Eating Disorder Plan (EDP), it's an evidence-based, best practice model of treatment.
The plan can include up to 20 Medicare-subsidised sessions with a dietitian and 40 sessions with a mental health clinician over a 12-month period.
If you're a clinician, or have specific questions, view the Frequently Asked Questions.
According to the Medicare Benefits Scheduling Book (pg 182-195), you may be eligible for an Eating Disorder Plan if :
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TIP You can pre-fill the EDE-Q and score yourself to prepare for your GP visit
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This is up to the GP to assess – remember to let them know about anything else going on in your life at the moment so that they can take it all in to account.
If you don’t think your doctor's decision on eligibility is correct, consider getting a second opinion.
Someone experiencing Bulimia Nervosa, Binge Eating Disorder or Other Specified Eating and Feeding Disorders (OSFED) can score 3 or higher on their EDE-Q if their symptoms are severe.
The amount of the refund varies depending on the practitioner, item numbers and where the consultation takes place.
Discuss and confirm costs and refunds with your treatment provider.
To be assessed for an Eating Disorder Plan (EDP), you can see a GP – it’s also possible to see a psychiatrist or paediatrician (if you already have one).
If you don’t have a GP you trust, contact the Butterfly Foundation Helpline so we can check if there’s a GP in your area with an understanding of eating disorders on our referral database.
Some GPs may not be aware of the recent changes to the Medicare Benefits Scheme or the eligibility criteria. If not, you can refer them to the MBS Online Eating Disorders page
To get prepared, you can search the Eating Disorder Examination Questionnaire (EDE-Q) online to help you think about all the ways your experience of an eating disorder may be affecting you. The EDEQ is also part of the assessment for an Eating Disorder Plan.
You may also wish to select a practitioner before you see a GP, rather than being referred to someone suggested by the GP. To do so, you can:
To find out more, check out ‘Finding a Practitioner’ section to see what you may need to consider.
Make sure you talk to your GP on this first visit about a referral to a psychiatrist for the halfway review which is critical in gaining access to the final 20 sessions. This is important, as psychiatrists often have long waitlists – you can always cancel if you want to.
After you are assessed, the GP will let you know if you are eligible for the EDP. You will then line up an appointment with your practitioner. There are a few more things to remember, especially considering that the treatment plan comes in 4 blocks of 10 sessions each – you will need to action some steps between these lots of 10 to ensure ongoing support.
We understand this might be difficult – remember there are other options…
Finding the right practitioner is important to make sure you’re getting all the support you deserve. Here are some important points to consider…
Mental Health Professionals who are registered with Medicare:
You may need to contact the practitioner you are thinking of going with to ensure they are able to administer the therapeutic treatment.
The practitioner has to be delivering one of the following treatments;
If you're a clinician or you'd just like more of the detail, please check out the Frequently Asked Questions.
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