Care plans work differently now

If you live with a health problem that keeps going, a care plan is one of the most useful things your GP can set up with you. The way these plans work changed on 1 July 2025 and the change is worth knowing about.

What a care plan actually is

A GP Chronic Condition Management Plan is a written plan your GP prepares with you. Medicare sets out what it has to contain.

It describes your chronic condition and the health care needs that come with it. It records health and lifestyle goals that you and your GP develop together. It lists the actions you will take and the treatment and services you are likely to need. It names any services you will be referred to. It also sets out when and how the plan will be reviewed.

You are offered a copy to keep. A copy goes into your medical record.

Who is eligible

You are eligible if you have at least one medical condition that has been present for at least 6 months or is likely to be. A terminal condition also qualifies.

There is no list of approved conditions. Your GP uses clinical judgement to decide whether a plan would help you. Long-running pain counts even where the underlying cause has not been identified yet.

You need to be living in the community. People who are care recipients in a residential aged care facility are not eligible for these plans.

What changed on 1 July 2025

The old system used two separate documents: a GP Management Plan and a Team Care Arrangement. From 1 July 2025 both were replaced by the single GP Chronic Condition Management Plan.

One part of that change matters more outside a capital city than in one. Under the old rules, team care could not be arranged until at least two other providers had been consulted and had agreed. That requirement is gone. Your GP can now refer you directly to the services named in your plan and no provider has to accept the referral before the plan is finalised.

The nearest physiotherapist, dietitian or podiatrist may be a drive away. Removing a step from that chain is a real difference.

If you already have an older plan

Plans that were in place before 1 July 2025 keep working. If you had a GP Management Plan and a Team Care Arrangement before that date, you can keep accessing services under them until 1 July 2027. Nothing needs redoing in a hurry. It is worth raising at your next appointment.

What a current plan can open up

With a GP Chronic Condition Management Plan in place you may be eligible for Medicare supported services each calendar year:

• up to 5 individual allied health services and up to 10 for patients of Aboriginal or Torres Strait Islander descent

• up to 5 services provided by a practice nurse or an Aboriginal and Torres Strait Islander health practitioner on behalf of a medical practitioner

• if you have type 2 diabetes, an assessment of your suitability for group allied health services and up to 8 group sessions if you are suitable

A referral from your doctor is needed for Medicare to pay a benefit on these services. If your referral does not state a period, it is valid for 18 months. That period is counted from the date of your first service under it, not the date it was written.

Keeping the plan current

A GP Chronic Condition Management Plan does not expire. To keep accessing allied health services through it, the plan has to have been prepared or reviewed within the last 18 months.

A plan can generally be reviewed once every 3 months. A completely new plan can be prepared once every 12 months, though a new plan every year is not required. For most people a periodic review does the job and the review is where goals get adjusted. Both can happen sooner where there has been a significant change in your condition or your circumstances.

A note on MyMedicare

If you are registered with a practice through MyMedicare, you access these services through the practice you are registered with. If you are not registered, you access them through your usual doctor.

Worth a conversation

If you have been managing a condition for a while and it has never been written down as a plan, ask our team whether one would suit you. It helps to come with two things: a list of what you are already doing and the one thing you would most like to change.

Your Health Griffith has been part of the Griffith community since 2006. We are at 105 Binya Street, Griffith. Phone 02 6962 7661. Appointments can be booked through HotDoc.

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Source: Medicare Benefits Schedule item 965, GP chronic condition management plan, published by the Australian Government Department of Health, Disability and Ageing on MBS Online. Explanatory notes AN.0.47 and AN.15.3. Item start date 1 July 2025. Accessed 21 August 2026.