Referral - Why and When do I Need a Referral to my Eye Specialist?

WHY AND WHEN DO I NEED A REFERRAL TO MY EYE SPECIALIST?

A referral from a GP, Optometrist or current specialist is required before an initial consultation with an Ophthalmologist in order to receive a Medicare benefit for that consultation.

One can still visit an Ophthalmologist without a referral but a Medicare benefit will not be paid towards the cost of that visit. This is so for many overseas visitors and for legal and insurance examinations.

In general, referrals from GPs and Optometrists are for 6-12 months and, from other Specialists, for 3 months.

Changes to Medicare have included the option of referring a patient to a specialist on an indefinite basis where long-term ongoing care of a particular condition is appropriate.

A difficulty may arise when a patient has been referred with an indefinite (ongoing) referral for a particular condition and subsequently develops another different disorder. The ongoing referral does not cover the second and different condition and a new referral must be obtained for that new condition. In such circumstances the patient can only receive a rebate for an "initial consultation in a single course of treatment" if appropriately referred.

Referral letters with an indefinite duration are suitable only where long-term and periodic monitoring or care of a particular condition is expected.

Standard referrals in the usual manner are required for a patient developing separate ophthalmic disorders which require the attention of an Ophthalmologist.