Patient Travel Subsidy Scheme eligibility To be eligible for PTSS, you must be: a Queensland resident or a patient with no fixed address eligible for Medicare accessing a specialist medical service that is: — recommended as medically necessary by your doctor — listed under Schedule 1 as an essential specialist medical service — not available within 50 kilometres of your nearest public hospital — the closest service of its type. Sometimes assistance is available from other sources, including the Department of Veterans Affairs or other third-party, insurance or workers compensation claims. However, when treatment is needed, the level of assistance may not be known or the assistance may not be available for a long time. Under these circumstances you may still be eligible for assistance under PTSS. However, please note that you may be required to pay back any PTSS subsidies should your claim from another source be successful. PTSS – Information for patients and carers Page | 5 Exceptions to eligibility If you have family or friends living near a service that is not the closest, you may be able to travel to this service even though it is not the closest if the total amount of PTSS subsidies is equal to or less than that which would have been provided to travel to the closest service. If you have been taken to a specialist medical service in an emergency situation (including as an inter-hospital transfer) you can be assisted with return travel and accommodation even if the service that you have been taken to is not the closest available, as long as the service is more than 50 kilometres from your closest public hospital. Note: this is only applicable within Queensland and you must meet all other criteria. Other requirements You must obtain approval for assistance prior to travel, unless you: — were not aware of the scheme and/or were not aware that you had to obtain approval prior to travelling—this exception is applied once only per patient — were not originally going to claim PTSS for your specialist visit, but need unexpected treatment when at your specialist appointment and subsequently want to claim PTSS — required urgent travel and did not have adequate time to apply — have travelled to receive treatment and subsequently require an escort to join you—approval must be obtained prior to the escort travelling. Note: you must satisfy all other criteria. Assistance will only be provided to the extent to which it would have been approved had the request been made in the usual manner: Where preliminary services can be provided locally (including through Telehealth), assistance will not be provided for these. If you require further or ongoing specialist treatment: — Where follow-up services (such as checking your progress or checking the condition of surgical wounds) can be provided locally, assistance will not be provided. — If a closer service is established you will be approved for one additional visit to your original specialist to ensure appropriate hand-over measures are taken. All following appointments must be to the closer service to be eligible for subsidy under the PTSS. Types of assistance PTSS provides subsidies towards the cost of travel and accommodation, however it does not cover all costs (Refer to What is not covered). If the PTSS subsidy amount does not cover all the patient’s travel and accommodation costs, the patient is responsible for covering the remaining costs. Note: patients and approved escorts are both this requirement under Schedule 4. It is important to note that the local hospital will only provide subsidies for what has been originally approved. In cases where follow-up, ongoing or further treatment is required (and not approved as part of the original application) approval must be obtained for any further subsidies beyond the original application. PTSS – Information for patients and carers Page | 6 Travel subsidies Your local hospital will provide travel subsidies for the most clinically appropriate and cost-effective mode of transport. Generally, the cheapest form of commercial transport (bus or rail) will be subsidised unless you are approved for a more expensive mode of transport (based on a clinical need and/or if commercial transport is unavailable). Commercial transport costs are covered from the transport terminal (airport, bus station or train station) in the town where your local hospital is located to the transport terminal in the town or city to which you are travelling. If you are required to travel more than 50km from their local hospital to reach the transport terminal, you are eligible for PTSS assistance for this leg of the trip. Once you have reached your destination, it is your responsibility to cover the cost of land transfers, which includes travel between the airport, train station or bus station and the accommodation or the health facility you will be attending. If approved for private motor vehicle travel, travel will be subsidised at 30 cents per kilometre and is calculated from the post office closest to your local public hospital to the post office (or General Post Office) of the town/city you are receiving treatment in. When you travel to a specialist service, you will need to return as soon as practicable after the completion of your treatment (e.g. as soon as transport is available), unless prior approval is granted for special circumstances. In the unfortunate case of requiring return transport for a deceased person, a relative will be provided with a subsidy equivalent to a full economy airfare, to the nearest airport to the deceased person’s normal place of residence. Accommodation subsidies Accommodation will only be subsidised for the minimum period you are required to be away from home for medical reasons. For PTSS travel on or after 1 January 2013, you and your escort (if approved) are subsidised at $60 per person per night when staying in commercial accommodation. If you and your escort (if approved) choose to stay with friends or relatives (i.e. private accommodation), you and your escort are subsidised $10 per person per night. One night’s commercial accommodation may be arranged if you would be travelling by car for more than 600 kilometres or for more than eight hours in one day. You would need to discuss this with the PTSS officer at your local hospital prior to travel. Note: the requirement for the patient and approved escort to both pay for the first four nights of accommodation (commercial and/or private) in each financial year still applies in each case (see Schedule 4). Patients may require accommodation prior to early morning appointment or admissions, or following late appointments. If you are away from home for an extended period of time, the need for accommodation subsidies will be reviewed every month.
Posted on: Sun, 08 Sep 2013 12:49:50 +0000
Trending Topics
Recently Viewed Topics
© 2015