Advocacy Services Frequently Asked Questions

Find answers below about the following topics:

Access to health care cards for 16-25 year olds with diabetes
Medicare items for Allied Health Services for people with chronic conditions and complex care needs
Cost of insulin
Access to the Multi Purpose Taxi Program
Getting the most out of a consultation with a diabetes health professional
Tips on advocating for yourself
Travelling overseas with PBS medicine
Travelling overseas and running out of insulin

Access to health care cards for 16-25 year olds with diabetes

Question:

Can my 17-year-old son who has just been diagnosed with type 1 diabetes get a Health Care Card from Centrelink? He is a full time student at secondary college.

Answer:

Yes, from the first of October 2007, young people aged 16 to 25 years continue to have access to Health Care Cards while they remain full time students.

Full time students aged 16 to 25 years now have access to some financial help with the ongoing medical costs associated with diabetes; for example, cost of insulin at the Pharmaceutical Benefit Scheme rate.

For more information and a copy of the 'Application for a Health Care Card – for former recipients of the Carer Allowance Health Care Card' call Centrelink on 13 27 17 or visit their website. To speak to Centrelink in languages other than English call 131202.


Medicare items for Allied Health Services for people with chronic conditions and complex care needs

Question:

Will Medicare cover the cost of me seeing a dietitian or podiatrist? I have diabetes and I'm on the Aged Pension with Centrelink.

Answer:

Yes, Medicare rebates are available for a maximum of five allied health services per patient in a calendar year. These Medicare rebates are available to patients with the following:

  • Have a chronic condition (for example diabetes or heart disease) and complex care needs (this could include the complications associated with diabetes for example peripheral neuropathy)
  • Being managed by their local doctor/GP under a Enhanced Primary Care (EPC) plan
  • The need for allied health services was identified in the patient's plan.

Eligible services include those provided by the following allied health professionals:

  • Aboriginal health workers
  • Audiologists
  • Chiropractors
  • Chiropodists
  • Diabetes Educators
  • Exercise Physiologists
  • Dietitians
  • Mental Health workers
  • Occupational therapists
  • Osteopaths
  • Physiotherapists
  • Podiatrists
  • Psychologists
  • Speech pathologists.

Your GP needs to complete the EPC Program referral form for allied health services under Medicare.

Cost of insulin

Question:

I require insulin to manage my diabetes.  How much is insulin going to cost me?

Answer:

Insulin is available on the Pharmaceutical Benefits Scheme (PBS) and a doctor's prescription is required.

As of May 2008 the out of pocket cost for your insulin is as follows:

  • If you are a Centrelink Health Care Card (HCC) holder then the cost will be $5.00 (3 ml cartridge x 25 or 10ml vial x 5)
  • If you do not have a concession card the maximum price will be $31.30
    (3ml cartridge x 25 or 10ml vial x 5)

If you hold a Medicare Safety Net entitlement card:

  • The safety net threshold for HCC concession card holders is $290.00. PBS medicines above this will be at no cost until the end of the calendar year.
  • The safety net threshold is $1,141.80 (PBS medicines above this will cost $5.00 per prescription until the end of the financial year)

For those who are not eligible to access the Pharmaceutical Benefits Scheme (PBS) the cost can vary between $158 – $432, depending on the type of insulin that has been prescribed by your doctor.

Visitors to Australia are advised to bring their insulin and diabetes supplies required during their stay.

For further information on the cost of insulin speak to your doctor or diabetes educator. For consumer medicines information talk to your local pharmacist or contact the National Prescribing Services Medicines line on 1300 888 763 or call Diabetes Australia – Vic on 1300 136 588.

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Access to the Multi Purpose Taxi Program

Question:

I have diabetes and this year developed diabetes complications affecting both my sight and balance, now making it impossible for me to use public transport. I receive the Aged Pension. Am I eligible for discounted taxi fares?

Answer:

The Multi Purpose Taxi Program is designed to help Victorians, who are prevented from using public transport because of a severe and permanent disability, to access subsidised taxi transport.

To be eligible for this program you need to be a permanent resident of Victoria and have a severe and permanent disability, which:

  • Severely limits mobility and prevents the use of public transport, enduring in nature  and/or
  • Prevents independent travel on public transport
  • You must be experiencing financial hardship and be a current Centrelink Concession Card holder.

To join this program you will need an application form to be completed by your doctor, which is then submitted to the Victorian Taxi Directorate. These forms can be downloaded from the Victorian Taxi Directorate website or by telephoning (03) 9320 4360 or for country callers phone 1800 638 802.

Multi Purpose Taxi Program members will be charged $16.50 for:

  • The initial membership card
  • Renewal of the membership card
  • Replacement of the membership card if it is lost or stolen.

Membership cards are valid for six years.

For further information on the Multi Purpose Taxi Program contact the Victorian Taxi Directorate phone during business hours (03) 9320 4360, Country Callers 1800 638 802, Postal Address: Multi Purpose Taxi Program P.O. Box 666 North Melbourne Vic 3051 or via email at mptp.taxitow@doi.vic.gov.au or via www.taxi.vic.gov.au.

Question:

My application for the Multi Purpose Taxi Program has been refused. Can I appeal this decision and what can I do?

Answer:

Yes, you can appeal this decision. Any person who currently uses this program can appeal a decision. To find out more about the appeal process and what documentation is required you need to take the following steps:

1. Contact the staff responsible for the Multi Purpose Taxi Program at the Victorian Taxi Directorate as they will need current medical information from your treating doctor on which to review your application and make a decision.

In order to prepare your appeal make sure that you:

  • Know what is required to present your case and tell your story
  • Have copies of any forms to be completed posted to you if you do not have internet access
  • Write down the name of the person that you are dealing with
  • Know the date by and, person and address that any completed forms have to be returned to
  • Know how long it will take for a decision to be made
  • Ask for a letter confirming the appeal process
  • Ask for any decisions to be formally noted in writing.

2. Make an appointment with your treating doctor and request a letter that clearly states and supports that you now have a permanent disability and are not able to use public transport. This information is vital to help the Multi Purpose Taxi Program staff make a decision on your behalf.

3. When presenting your case make sure that you have your documentation organised so that it is easy to find and if you need further help with the appeal process outside your family and friends you can call the Advocacy coordinator here at DA–Vic on 1300 136 588.

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Getting the most out of a consultation with a diabetes health professional

Question:

I have just been diagnosed with diabetes and everything is so new and I have many appointments/consultations with doctors and other professionals. How can I get the most out of an appointment with my diabetes health professionals? Can I ask for a second opinion?

Answer:

Hearing the news that you have diabetes does take a while to get used to, not to mention the many appointments with doctors and other health professionals that you need as you learn to live with this condition. Communication is a vital part of diabetes care and here are some suggestions that might help you get what you need from consultations with diabetes health professionals:

1. Prepare yourself beforehand

Make a longer appointment
Health professionals are always busy, so if the issue you want to discuss is complex or you need to discuss several matters, ask for a longer appointment when making your booking. You and your health professional may feel less pressured and more able to concentrate on discussing your problems.

Prepare a summary
If possible write a summary of your medical problems and health concerns, and put the most important to you at the top. Take your list with you and offer it to the health professional at the start of your visit, or perhaps post it to them a week or so beforehand. Keep a copy for yourself, so you can tick off the issues as you go.

Make a list of questions
In the week before your appointment, make a list of your questions as you think of them. Make two copies of the list, so you can give one to the doctor or health professional and keep one for yourself.

Leave space below each question, so you or the health professional can write down the answers. Check the list before leaving to make sure that your most important question(s) have been answered. You may need to make another appointment to work you way through your list.

Also give consideration to taking a tape recorder to your appointment especially if you have sight impairment, difficulty writing or have to attend the appointment alone. Recording the discussion could be a helpful reference for later. Please check this out with the doctor or health professional before your consultation.

2. During the appointment

Be honest and ask questions
Give your doctor or health professional a complete picture of your symptoms, how you're feeling, and the key issues as you see them.

Tell your doctor or health professional if you don't understand something, and ask them to repeat the explanation or recommendation until you do understand. This information or answer may be vital to your health and well- being.

Take another person
It may help you to feel confident about handling any aspect of the appointment, if you take a relative or friend with you. They can be your second set of ears, your notetaker or your advocate.

Take notes and request information
If you think that you may have trouble remembering any important details, write them down at the time, or ask your doctor/health professional or relative to do so for you.
If you want to learn more, ask the doctor/health professional if they have any written information or suggestions of where you might obtain such information.

3. After your appointment

Make a follow-up appointment
Organise a follow-up appointment to monitor your progress, ask further questions, discuss outstanding issues, or tell the doctor/health professional of your decisions after time to think and discuss matters with those close to you.

Get another opinion
If you want to discuss your health problem or concerns with another health professional, you can seek another opinion. This can be another doctor, specialist or someone who looks at the problem from a different perspective, such as a diabetes educator, social worker, dietitian, pharmacist or psychologist.

Finding another doctor
If you don't feel comfortable with your general practitioner (GP), and don't think that things will improve soon, consider seeking another one (if this is possible). If you don't feel comfortable with your diabetes specialist, tell your GP. They may be able to refer you to another. Your health and well-being will be best served if you and your doctor trust and respect each other, and work together as a team.

Do some research before making your choice: ask trusted friends, family and neighbours. Sometimes, it helps to check out costs, websites, and brochures of possible doctors. Ask whether the practice is open outside of business hours, if they are taking new patients, if the doctors have an interest in diabetes, if they conduct home visits, how you will be billed and whether interpreting services are available if required.

If you have access to the internet, the easiest and most up to date way to find a health professional in your area is to use the health services directory.

Other useful sites are listed below:

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Tips on advocating for yourself

Question:

Do you have any suggestions on how I can advocate for myself on a problem that I have as a person with diabetes?

Answer:

We support self-advocacy to better equip people with diabetes, and their family members to manage their concerns, so you can approach the future with new skills and confidence. The following tips may be of assistance:

Goals & Objectives

  • Be clear about the outcomes that you are aiming for. Make notes and date any information gathered. For example, before your child with type 1 diabetes is to start primary school, your goal is to ensure that the school has a diabetes action plan in place before the school term starts.
  • Review actions at regular intervals and make changes as needed.

Planning and researching your area of interest, presenting your case and taking care of your self are vital for positive change.

Planning and researching your area

  • List the issues/concerns that are most important to you.
  • Think about what actions may be necessary to achieve your goals- write these intended actions down. Make sure these actions are divided into small achievable tasks to help you achieve better outcomes
  • Gather any relevant facts, figures or documents necessary to argue your case. For example, you may use the DA–Vic website information and or speak with the advocacy coordinator for help with your research.
  • Know the 'rules of the game'. For example, seek out any guidelines, policies and or relevant legislation which may support your case. Reference this information so you can refer to it at a later date.
  • Have your documentation sorted out so that items are easy to find. For example, use an expanding file and ensure dates are on all correspondence.
  • Take notes of key points in meetings and keep all handouts. Where possible ensure that your are on a mailing list to receive any minutes taken at any meetings.
  • Be prepared to take follow- up action from any meetings to ensure that tasks agreed are actioned.
  • Organise any follow- up discussions or meetings by first checking your own diary.

Presenting your case

  • Understand all the issues involved as best you can
  • Think about the arguments others may use and how you might best respond
  • Know what options are available to resolve the situation
  • Be prepared to compromise and or concede unimportant points
  • Ask for important issues and decisions to be formally noted in writing
  • Record all of the issues you have agreed on and most importantly try to find a strategy for dealing with any disagreements
  • Don't accept indecision or lack of action by others. If people have not followed through on assigned tasks hold them responsible. Inaction could be holding up outcomes and delaying the process
  • If applicable, make sure there is an agreed process for follow-up
  • You might consider taking another person to advocate on your behalf or support you in the process. Sometimes another person will remember points that you have missed.

Dealing with the emotional impact and seeking support

  • You are acting because you are passionate about an issue: where possible be calm, positive and keep your sense of humour
  • If you need to draw on emotion, that's okay- but always remain calm
  • If you need to, stop count to 10 and think about what you are going to say next
  • Others might agree with you, but you should be prepared for conflict or disagreement
  • Remember to respect the points of view of others
  • Be assertive. Assertiveness is sometimes confused with aggressiveness, but it is distinctly different. Aggressiveness violates the rights and preferences of others, where as assertiveness is necessary to ensure recognition of, and respect for, your opinion and point of view
  • Don't allow others to intimidate you. Be yourself and avoid talking in jargon
  • Where possible, have trusted friends that can listen and support you as needed
  • You may not be alone with an issue of concern. If appropriate and suitable join in with others. You can call on others in your community and discuss matters with DA–Vic's advocacy coordinator
  • Stop, review, and take a breather. Check how you are feeling. If necessary call for a short break to gather your energy for the next matter of concern!


Travelling Overseas with PBS medicine

Question:

Early next year I will be working overseas for three months and want to know if I can send over some of my diabetes prescription medicines?

Answer:

Yes you can. The current legislation allows for you to send, Pharmaceutical Benefits Scheme (PBS) medicine overseas if it is for your own personal use, or the use of someone who will be travelling from Australia with you.  The instances where this is allowed is when you will be travelling via a country in which the medicine is illegal, or when you would need to carry a large amount. You need to ensure that you do the following;

  • First, check with that your medicine is considered legal in the country of your destination. Travellers should contact relevant embassies before leaving Australia.
  • Second, enclose with the medicine a letter from your doctor detailing what the medicine is, how much you will be sending and stating that medicine is for your personal use. Ensure that you leave the medicine in its original packaging. If you are unable to get a letter from your doctor, Medicare Australia's Medicine Export Declaration may be sufficient to satisfy Customs that the medicine is for your personal use.
  • Third, attach to your parcel a completed Customs declaration available from any post office, disclosing that the package contains prescription medicine that is for your personal use.

Customs may detain any medicine they suspect is being illegally exported. It is therefore in your best interest to provide the correct documentation.

There are also restrictions on the amount of PBS medicine you can send overseas. Staff within the Australian Customs Service advises that generally you are allowed to take a three month supply. For permission to take a longer supply and other PBS medicines information, please contact Medicare Australia on 13 20 11 or visit their website www.medicareaustralia.gov.au

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Travelling overseas and running out of insulin

Question:

My child is overseas and is running out of his insulin. Am I able to get insulin to him or help him to access insulin overseas?

Answer:

Yes, there are two methods suggested by Medicare Australia to help your child secure insulin whilst overseas.

1. Have your child contact and consult their regular medical practitioner in Australia, to see if they can obtain a non – Pharmaceutical Benefits Scheme (PBS) prescription for their insulin. This non-subsidised prescription will mean that a pharmacist in Australia can supply them with insulin and then arrange to have this medicine packaged and delivered directly to their overseas address. The cost of their insulin will be at the full price. If you decide on this option it is important that you contact the following;

  • The Australian Customs Service prior to the medicine being sent or taken overseas to ensure that the medicine is not a prohibited export and that it may be legally exported;
  • The embassy of the country to which the medicine is being sent to ensure that the medicine can legally be imported into that country.

So that Customs is aware that your child's insulin is not PBS-subsidised medicine, it is recommended that you ask your pharmacist for a letter stating that the medicine has not been subsidised. If you are unable to obtain this letter then have a Medicine Export Declaration completed which is available from Medicare Australia. Enclose this letter or declaration with the insulin when sending this to their overseas address.

2. Have your child consult a medical practitioner in their overseas destination and obtain the insulin if available, in that country. You can check the availability of insulin overseas by contacting the relevant drug companies' customer care phone line in Australia.

The Australian Government has also arranged reciprocal health care agreements enabling access to health care in certain countries. A listing of these countries is located on the Medicare Australia website.

For further information on travelling with diabetes call Diabetes Australia – Vic on 1300 136 588.

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