Forum Discussion

arpie's avatar
arpie
Member
21 days ago

Medicare Update for High Risk Breast Screening

Have you had an MRI AND Ultrasound on the same day?  Did you receive the Medicare rebate on BOTH items?

I think this is more to do with 'new diagnoses' - not existing ones - but if you require an ultrasound AND MRI on the same day - make sure you ask the questions about being able to claim the medicare rebate on BOTH!

As of today (1st July 2026) those having MRI AND Ultrasound, may be able to have them on the same day and claim both the  Medicare rebates.
Previously - they had to be done on 2 different days to be able to claim both rebates.

This will make it more 'time efficient' and less stressful, reducing out of pocket expenses -  particularly for rural/regional/remote patients (for example) who would have to have stayed an extra night to have the 2nd procedure otherwise!

 

 

 

 

mri
ultrasound

4 Replies

  • arpie's avatar
    arpie
    Member
    19 days ago

    Minnie18​ - Do you KNOW why you do not get the rebates?  Have you asked why?

    How old are you and what was your diagnosis?  I would have expected that once diagnosed, you should be 'covered'!  grrr 

    I am so sorry you are copping all these out of pocket charges - I had it with my surgery (but my Surgeon had advised me of that tho), then my pathology wasn't fully on medicare ($500 there), lots of shortfalls with other bits (lesser amounts) tho when I had bone pain, I was hit with the full fee, as it was less than 2 years since my previous scan ......  so probably over $7000 in my 8 years since diagnosis.

    My own diagnosis was missed by Breastscreen NSW when the mammogram didn't pick up my 2 x lesions - and they missed it again, when I suggested they re-check it (knowing that I DID have BC) .... and they missed it again!

    My first ultrasound also missed it - but at least they suggested a biopsy - which found it in 2 spots.

    take care & all the best with your ongoing scans & treatment xx

    • Minnie18's avatar
      Minnie18
      Member
      19 days ago

      Hi Arpie.  I was 48 when diagnosed and finished all my treatment mid last year.  It started really simply with me finding a lump and a lumpectomy to be followed by radiation.  Then they found more in surgery and MRI after found even more. I was dumbfounded as I had no understanding that scans don’t always show it.  After more surgery, chemo and radiation,  I will now only be monitored with MRI.  I’m guessing my future out of pocket costs are because I was sent for scans already earlier this year as they were monitoring my other breast.  Luckily that was clear.  I am so grateful to be healthy again and though I can afford the scans whilst working (though have to save), I worry about how to afford them in the future if I am not working.  I also worry for those with less than me who would find it much harder to pull together the money.  I was glad to see your post though to see there is some common sense prevailing.  The idea you’d have to come back on another day to be able to get a rebate is ludicrous.   I remember being in shock at an onc appointment half way through chemo when the assistant I was paying told me my onc couldn’t see me the next fortnight if I didn’t arrange for a new referral from my GP.  This happened numerous times with the oncologist/ surgeon before I had a different gp do the referral that would have no cut off date.  This will save me future stress and money.  I’m glad you persisted and advocated for yourself and they found it so you could get treatment.  We are lucky to have you here sharing and supporting us.   

      • arpie's avatar
        arpie
        Member
        19 days ago

        Thank you for telling us a bit more of your story too xx  Every bit of info gleaned from others will help someone who is just starting out xx

        Yep, we need to be our own advocates .... LOUD, if need be!!   

        My own mantra is:
        IF IN DOUBT, GET CHECKED OUT!

        As you say Minnie18​  - it is LUDICROUS to force appts on different days as it is just more stress & inconvenience, specially if you have a young family or other responsibilities/commitments! But particularly if you live in rural/regional/remote areas - where it means you then need to spend another night there as well ... which then costs the Gov even MORE, as they are usually paying for the accommodation as well the scans!  DUH! 

        That's great that you have the Indefinite Referral with your Onc now xx. I do too .... I was just wondering the other day if that means I can just arrange an appt with her (now that I've officially signed off with her after 7 years) in case I have a query!!   

        ALL cancer patients should be offered Indefinite Referrals right at the start - as they are guaranteed to be seeing their Onc/Surgeon for a minimum of 5 years - and just adds more stress & costs to the patient (AND the Gov) by forcing unecessary medical appts just to get a bit of paper signed off - AND overloads the GP's books, preventing others from getting appointments!  grrr 

        I haven't had a whole body MRI/CT yet ....  I honestly believe it should be done in the first year of treatment (after diagnosis) on ALL cancer patients - as it is a 'snapshot' of their body at THAT moment in time .... so that when/if anything else is diagnosed later - they can go back & check that scan to see if they missed anything at the time!!  Sometimes, it may even pick up progression EARLIER - so they really know what they are dealing with!

        Take care xx

  • Minnie18's avatar
    Minnie18
    Member
    20 days ago

    Thanks Arpie for this update and for all the posts you provide with info and updates.  It is great to hear this change.  I have been shocked by the different rules around rebates and also the costs associated with diagnosis, treatment and monitoring.  I am currently saving the next $800 of out of pocket costs for my next surgeon appointment and MRI in October.  Not to mention trying to have an extra $1100 available for the out of pocket cost I’ll need if I need an MRI guided biopsy.  My breast density meant that my original tumours weren’t visible by mammogram or ultrasound.  Anything this network can do to advocate for the reduction of out of pocket costs for us would ease the stress during diagnosis, treatment and ongoing monitoring.  One win I finally had was my GP sent my oncologist and surgeon perpetual referrals so I didn’t have to keep seeing them and paying for referrals.  This eased some of the stress and I recommend others ask for the same.