WHEN Elise Krupka lodged her claim with Medicare after paying a $1400 doctor’s fee for her daughter’s surgery, she thought she would wait for a refund before she paid the anaesthetist’s bill.
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That was at the start of December. Nine weeks later, she is still waiting.
The mother-of-three from NSW eventually had to take the money off her mortgage to pay for the anaesthetist, and says she is now owed more than $1400 by Medicare.
In the past two months she has lodged the forms in three different ways, sent several emails and made more than 30 phone calls, but she is yet to receive a response from Medicare, or speak to a human.
“I have phoned the Medicare number at least 30 times and every time I get an automated message saying they are receiving an overwhelming number of calls and to call back again, and then it cuts you off,” she said.
“I’ve phoned at different times, and still the same message.
“I’ve emailed Medicare and the automated response was that ‘we can’t process any of your private information via email, so please phone the number’.
“It’s a vicious circle.”
The Krupkas have joined other fed up patients, out of pocket hundreds of dollars and waiting months for Medicare refunds, to call for action.
Since changes to operations in recent years, including the merging of Medicare and Centrelink offices, there have been widespread reports of lost forms and long delays in receiving reimbursements for eligible medical appointments.
Mrs Krupka’s four-year-old daughter Nevaeh Krupka had surgery to remove her tonsils and adenoids on October 31 last year. Within a week of paying the $1400 doctor’s fee in late November, Mrs Krupka lodged her form with Medicare through the Raymond Terrace Centrelink office.
Then nothing, she said.
Two weeks later, on December 16, she sent another form through the post.
More than a month later, after researching what she should do, she downloaded the Medicare app and, on January 24, she lodged the claim again.
“I still have not had a single piece of correspondence from Medicare,” she said.
“I’m literally just butting my head against the wall. I have lodged it three different ways and I haven’t heard anything.”
A Department of Human Services spokesperson said late on Saturday that by their records Mrs Krupka’s claims had been processed and paid last year, and the department would contact her to discuss any outstanding concerns.
Couple John and Narelle Bailey waited 10 weeks for their Medicare refund following a visit to a specialist last year.
Mr Bailey said the couple lodged their form at Centrelink, and later lodged a second form.
They were eventually paid, 10 weeks after the initial claim was lodged, Mrs Bailey said. Later, when she had to lodge another claim, Mrs Bailey decided she had had enough.
“The next time it was going into about the sixth week and I thought, no, I’m not going through this again,” Mrs Bailey said.
“I contacted (local MP for the Hunter) Joel Fitzgibbon.”
Within four days, the Baileys received their second refund.
Mr Bailey said it was unfair for the government to try and force people to use the Medicare app when a doctor did not have the reimbursement swipe facility at their practice.
“They are trying to get everybody with a mobile phone to use the app, which is fine if you’ve got a mobile phone, but I just don’t trust it,” he said.
Mr Bailey also said there was a lack of support.
“There’s nobody in Centrelink anymore, there’s nobody in Medicare,” he said.
Department of Human Services general manager Hank Jongen said claim processing times could vary “depending on the nature and complexity of the claim, workloads and seasonal and operational issues”.
“Where claim processing times increase, additional staff are allocated so that service standards can be maintained,” Mr Jongen said.
He rejected suggestions people were being forced to use the app.
“We are encouraging people to go digital, not forcing them, because it is the most convenient way to make a Medicare claim,” he said.
“Most people already choose to do their Medicare business through digital channels, such as claiming directly at medical practices. This is the quickest and easiest way to receive your rebate and we encourage customers to ask their local GP or specialist if this option is available at their surgery.”
Mr Jongen said Medicare shopfronts were not closing.
“Medicare shopfronts have been progressively co-located with Centrelink across Australia since 2009,” he said.
Member for Paterson, NSW Meryl Swanson this week urged everyone to share their Medicare experiences on an online portal mymedicarestory.com.
“The Turnbull government must drop the savage cuts to Medicare which has already caused bulk billing rates to fall, and people to pay more for vital healthcare services,” Mrs Swanson said.
“The government has made it so hard for people, they are sometimes in despair trying to deal with Medicare, just as they are with Centrelink.”