Genetic Carrier Screening Medicare Rebate in Australia - Terms and Conditions

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 Carrier Test, effective from November 1st, 2023.

Coverage:

Medicare will provide coverage for the Core Carrier Test, designed to screen for cystic fibrosis (CF), spinal muscular atrophy (SMA) and fragile X syndrome (FXS). The rebate is available once per lifetime to people of chromosomal female sex who are pregnant or planning a pregnancy under item number 73451, and once a lifetime per condition for reproductive partners of female carriers of CFTR or SMN1. A Medicare benefit of up to $400 is available to offset the associated costs.

Eligibility Criteria:

To qualify for the Medicare rebate, the following eligibility criteria must be met:

• Valid & current Medicare number
• Chromosomally female
• Pregnant or planning a pregnancy
• Australian citizen or permanent resident
• No previous benefit for this test
• Our registered medical practitioners determine if the test is right for you

Payment and Reimbursement:

If you meet the eligibility criteria mentioned above, you have the option to select the "bulk-bill" Core Carrier Test, in which case no upfront payment is required. However, if it is later determined that you do not meet the eligibility criteria, an invoice for the full test cost will be issued, which must be paid before the test can be conducted. If you are eligible, you also have the option to pay in full and claim the benefit yourself directly with Medicare once you have received your results.

Application for Rebate:

After the purchase of the "bulk-bill" Core Carrier Test is complete, you will be sent an email with access to your Eugene account where you will be asked to provide your Medicare number, health history, consent to do the test and assign your rights to Medicare benefits to the lab (so they can bulk bill for you). At this point, we may perform a check in the Medicare system that the number you provided is eligible. You can access and edit your responses in youraccountup until your sample is sent to the lab. 

You do not need a referral from your medical practitioner to access the Medicare rebate - we take care of that for you.

Exclusions:

Please note that all other genetic tests available on eugenelabs.com, excluding the Core Carrier Test, are not currently eligible for a Medicare rebate at this stage. No discounts apply to the Core Carrier Test, and Eugene gift vouchers cannot be used as a payment method for this test.

These terms and conditions are binding and pertain to the Medicare rebate associated with the Core Carrier Test 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.