Document ID: chunk:federal_register_of_legislation:F2023L00674:clause:6_1
Version: federal_register_of_legislation:F2023L00674
Segment Type: clause
Provision Reference: sch 6 cl 1
Character Range: 29989–34566

1  Section 15.5.7
   Repeal the section, substitute:

15.5.7    Medical costs
1.  A member who has met the minimum threshold under section 15.5.7A is eligible to be reimbursed out-of-pocket expenses incurred for medical goods or services received by an eligible person.
2.  Costs associated with assisted reproductive services provided overseas are not reimbursable.
3.  In this section, medical goods or services means any of the following.
    a.                                                                                                                                                                                           Medical goods or services that the eligible person would be entitled to receive under a Medicare benefit in Australia.

    b.                                                                                                                                                                                           Medical goods or services that are covered by another Australian Government funded scheme that meets all of the following.

                                                                                                                                                                                                 i.                                                                                                                          The eligible person would be entitled to receive the goods or services through the scheme in Australia.
                                                                                                                                                                                                 ii.                                                                                                                         The decision maker is satisfied that the medical goods or services the eligible person would be entitled to receive under the scheme are not otherwise provided for by local arrangements in the member's overseas posting location.
4.  In this section, decision maker means any of the following.
    a.                                                                                                                                                                                           Director National Operations, Joint Health Command.
    b.                                                                                                                                                                                           Director Directorate of Clinical Services, Joint Health Command.

15.5.7A    Minimum Thresholds
1.  For the purpose of section 15.5.7, a member must reach the following minimum threshold in out-of-pocket medical expenses for the eligible person.
    a.                                                                                                                                                                                                                      If the eligible person is less than 15 years old at the beginning of the financial year, the minimum threshold is AUD 25.
    b.                                                                                                                                                                                                                      If the eligible person is 15 years or older at the beginning of the financial year, the minimum threshold is AUD 69.
2.  If a member is only eligible for part of the financial year, the minimum threshold is reduced using the following formula.

    Where:
    A                                                                                                                                                                                                                       Is the threshold that applies to the eligible person under subsection 15.5.7A.1.
    B                                                                                                                                                                                                                       Is the number of days that the eligible person will be in the posting location that financial year.
3.  If a member incurs a cost for an eligible person's medical treatment in Australia in a financial year, the minimum threshold for that person in the financial year is reduced by the out‑of‑pocket cost to the member.
        Note: The threshold is not reduced by any amount refunded by Medicare or under an Australian Government funded scheme.