Generation IV of V · Medicare
Medicare and genetic tests
Medicare pays towards many genetic tests: the Health Minister’s release on new rebates says more than 376,000 genetic and genomic tests were subsidised in 2022–23. Most Medicare-funded genetic tests require a patient to meet clinical or family history criteria, and the same release describes newer rebates open to everyone.
General information, not medical advice. Call Triple Zero (000) in an emergency, or go to the emergency department of your nearest hospital. The official consumer page to check is healthdirect’s page on genetic testing.
Medical route
From a first appointment to a result
Put together from healthdirect’s page on genetic testing, the medical route runs like this:
See a doctor or genetic counsellor. healthdirect says this is the best first step if you are thinking about a test.
Counselling. A doctor or an allied health professional can give genetic counselling, which offers information and support to people considering a test, among others.
The test. Genetic tests are usually done at special laboratories, and most are blood tests.
Understanding the result. healthdirect calls this the important part, and says to talk it through with a doctor or genetic counsellor.
Genetic counselling explains the second step in more detail.
Rebates announcement
The genetic testing rebates announcement
A media release from the federal Health Minister, “$148 million in new Medicare rebates for genetic testing”, published on 1 November 2023, announced a package of new rebates. These are its figures, as the release gives them:
- 34
- new, expanded or increased Medicare rebates for genetic testing
- 112,000
- people each year who will benefit from them, the release says
- $148.5 million
- the investment over four years
- 85,000
- people each year expected to benefit from the reproductive carrier testing rebates
- $300–$340
- the rebate each parent was to receive for the carrier test, depending on whether they are treated in or out of hospital, as the release put it
- 376,000+
- genetic and genomic tests subsidised under Medicare in 2022–23, about $76.8 million in benefits
These are the release’s own figures from 1 November 2023. A media release is an announcement, not the Medicare Benefits Schedule itself.
Carrier testing
Reproductive carrier testing and Medicare
The release says the reproductive carrier testing rebates let couples learn their combined chance of having a child with one of three conditions: cystic fibrosis, spinal muscular atrophy and fragile X syndrome. Women who are pregnant or planning a pregnancy, and their reproductive partners, can give a blood, saliva or cheek swab sample.
What sets these items apart is who can have them. Most genetic tests funded by Medicare need patients to meet certain clinical or family history criteria; the release says these rebates are available to everyone, even with no symptoms and no family history. Types of genetic test explains what carrier screening is.
The same release says Medicare rebates would also become available for genetic testing to diagnose mitochondrial disease.
New items
How new tests reach the schedule
According to the release, genetic and genomic services are added to the Medicare Benefits Schedule (MBS) regularly, in response to recommendations of the independent Medical Services Advisory Committee.
Tests bought online
Tests bought directly
healthdirect notes that genetic tests can be ordered online without seeing a doctor, and passes on a warning to be careful about this. It adds that some of the companies selling them are based overseas and may take less care with privacy than Australian companies, so your private information could end up with others.