The Australian Government is committed to facilitating access to genetic carrier screening to help identify individuals at increased risk of having a child with an inherited genetic condition. These terms and conditions outline the eligibility criteria, coverage, and payment processes for the Medicare rebate for the Core and Couples (Medicare) Carrier Test, effective from November 1st, 2023.
The Carrier Screening Medicare benefit is a once-per-lifetime benefit of $340 to screen for Cystic Fibrosis (CF), Spinal Muscular Atrophy (SMA), and fragile X syndrome (FXS).
This rebate applies to females only. Male partners can be tested after the female’s results are available. If the female is a carrier for CF or SMA, we can then test the male partner for that specific condition at no additional cost.
Eligibility Criteria
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Valid and current Australian Medicare number
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Chromosomal female who is pregnant or planning a pregnancy
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No prior benefit claimed for a carrier screening test from November 1st, 2023 onwards
How to check your Medicare claim
You can confirm whether you have previously claimed this benefit by checking your MyHealth or MyGov account:
- Log in to my.gov.au and go to your Medicare section.
- View your Claims history and look for claims over $300 (from November 2023 onwards).
- Open the claim details and look for MBS item 73451 as shown below
If you haven’t received results from your previous test, we recommend contacting your GP or Specialist to obtain a copy. Please note that the provider name shown on your claim may be that of the laboratory pathologist.
Payment, Reimbursement, and Application for Rebate
Place your order for the relevant medicare-funded test from our website, referrals are not required to be submitted to access this rebate.
Log in to your Eugene account to complete onboarding, provide your Medicare number and assign your rights to Medicare benefits to the lab (so they can bulk bill for you).
We may perform a check to ensure the medicare number you provided is eligible. You can update your responses in your account up until your sample is sent to the lab.
Medicare will cover two types of tests:
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Core Carrier Screening - bulk-billed test option doesn’t require upfront payment.
If you are later found ineligible, an invoice for the full test cost will be issued, which must be paid before the test can be conducted. If you choose not to proceed with testing after the kit has been shipped, the shipping fees will be non-refundable.
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Couples Carrier Screening - A rebate of $340 is automatically applied, reducing your out-of-pocket cost to $949 at checkout. This out-of-pocket amount cannot be claimed through any additional benefits.
If you are later found ineligible, an upgrade to the couples Comprehensive Carrier Screening test is available as it is not linked to Medicare. If you choose not to proceed with testing after the kit has been shipped, a $100 administration fee will be deducted from your refund.
Exclusions
Carrier screening is not currently covered by private health insurance.
No discounts apply to the medicare-funded tests.
These terms and conditions are binding and pertain to the Medicare rebate associated with the Core and Couples Tests for genetic carrier screening. By proceeding with the test, you acknowledge and agree to comply with these terms and conditions. Medicare retains the right to amend these terms at its discretion. For further information or inquiries, please contact the Medicare office or visit their website for updates.
