Cost is one of the more common reasons women delay getting help, and it is rarely set out plainly anywhere.
This page covers what you can expect to pay to see someone. It does not cover the cost of specific treatments, which depends entirely on what you and your doctor decide and is not something a website can sensibly quote.
Seeing a GP
No referral needed. A GP is the usual first stop.
Medicare rebates apply. Every GP consultation attracts a rebate. What you actually pay depends on whether the practice bulk bills.
- Bulk billing — the practice accepts the rebate as full payment and you pay nothing. Fewer practices bulk bill all patients than a decade ago, though many still bulk bill concession card holders and under-16s.
- Private billing — you pay the practice fee and Medicare refunds the rebate. The difference is the gap.
Long appointments
Worth understanding, because it is where most of the confusion sits.
A standard consultation is typically up to about 20 minutes. A long consultation runs beyond that, and attracts a higher rebate — but practices usually charge a higher fee too, and the gap is often larger in dollar terms.
Menopause is a poor fit for a standard appointment. There is a history to take, a symptom picture to work through, and options to discuss. Trying to do it in 15 minutes is the most common reason women leave feeling unheard.
The practical advice: book the long appointment, and ask what it will cost when you book. Paying a larger gap once usually beats paying a small gap three times for a conversation that never quite happens.
Asking about cost
Entirely normal. Receptionists field this constantly.
Worth asking:
- Do you bulk bill, and does that depend on concession status?
- What is the fee for a long consultation, and what is the rebate?
- So what is the gap?
- Is there a GP here with an interest in menopause?
If the gap is more than you can manage, say so — some practices have discretion, and reception will usually know.
Tests
Blood tests ordered by a GP and done through a pathology provider that bulk bills Medicare are generally at no cost to you. Some tests are not covered by Medicare, and some providers charge a gap.
Ask when handed the form: "Will any of these have an out-of-pocket cost?"
Psychology and allied health
Two Medicare pathways are worth knowing about, because a lot of women never hear about them.
Mental health treatment plan. If anxiety or low mood is part of the picture, a GP can prepare one, which gives rebates for a number of psychology sessions per calendar year. There is usually still a gap, but it is substantially less than the full fee. Relevant because cognitive behavioural therapy has good evidence both for anxiety and for coping with menopause symptoms.
Chronic disease management plan. Where a chronic condition is involved, a GP can prepare a plan giving rebates for a limited number of allied health visits per year — physiotherapy, dietetics and others. Worth asking about if pelvic floor physiotherapy is relevant to you.
Neither is automatic. Ask.
Specialists
If a GP refers you on — to a gynaecologist or endocrinologist — specialist fees are higher and gaps are usually larger. A referral is required for the rebate.
Most menopause care is managed perfectly well in general practice. Referral is usually for complex situations, early menopause, or where something else needs excluding.
Lower-cost options
Community health centres in most states offer low-cost or free appointments. Waits are longer.
State women's health services exist in most jurisdictions and often provide free or low-cost care, sometimes with menopause-specific clinics. Search your state health department's site.
Public menopause clinics exist in some hospitals. They generally need a referral and often have long waitlists, but they are free.
Concession rates. Many practices bulk bill or discount for concession card holders. Always mention a card when booking.
Telehealth
Video and phone consultations attract Medicare rebates in defined circumstances, which generally require an existing relationship with the practice. The rules have changed several times, so ask the practice directly rather than assuming.
Telehealth widens your options considerably if you are rural, or if nobody nearby works in this area. It does not remove the requirement for a real-time consultation with a doctor — a service offering assessment by questionnaire alone is not following the Medical Board's guidelines.
Making the money count
Go prepared. The single biggest saving. An appointment where you have your symptom record, your cycle history and your questions written down achieves in one visit what three unprepared visits might not. See preparing for your appointment.
Book the follow-up. Most approaches need reviewing. A planned shorter follow-up is cheaper than starting again.
Keep your own notes. What was decided, what to watch for, when to return.
Related
How to find a GP who knows menopause covers where to look. Preparing for your appointment covers how to get the most from the time you pay for.