Chronic Disease Management in Point Cook

What counts as a chronic condition

Services Australia describes eligible conditions as those present, or likely to be present, for six months or longer, or a terminal condition. Conditions we commonly plan for include:

• type 1 and type 2 diabetes
• asthma and COPD
• high blood pressure and heart disease
• arthritis and long-term pain
• kidney disease

Whether a plan suits you is decided with your GP at the appointment.

How chronic disease management in Point Cook works now

The current Medicare rules for a GPCCMP:

• Your GP writes the plan with you: your goals, the care you need and who will provide it.
• If you are registered with a practice through MyMedicare, the plan and its reviews must be done at that practice. Otherwise your usual GP prepares it, meaning the practice that has given most of your care over the past 12 months, or will over the next 12.
• A plan can be reviewed as often as every three months, or sooner if your condition changes a lot.
• Medicare rebates may apply for up to five individual allied health services a calendar year, or up to 10 for Aboriginal and Torres Strait Islander patients.
• Referrals last for the period written on them, or 18 months from the first service if none is given.
• People with type 2 diabetes may also be eligible for an assessment and up to eight group sessions.

If you had a GP management plan or team care arrangement before 1 July 2025, Services Australia confirms you can keep using services consistent with it until 30 June 2027. After that a GPCCMP is needed, so raise it at your next visit.

MyMedicare registration

We invite patients who see Point Cook Doctors as their regular clinic to register for MyMedicare. Registration is voluntary and does not change your Medicare rights. Our Patient Info and Fees page explains how to register.

What happens at a planning appointment

Your GP goes through your history, medicines and results, checks blood pressure and weight, and asks what matters most to you. Together you set goals, agree on referrals and pick a review date. Australian Clinical Labs has a pathology collection centre in the clinic, open Monday to Friday 8:30am to 4pm and Saturday 9am to 12:30pm.

What to bring

• a list of every medicine you take, including supplements
• recent specialist letters and results
• home readings, such as a blood pressure diary
• your Medicare card and your questions

Care for specific conditions

Our diabetes care page covers the yearly cycle of checks. Asthma and COPD care centres on action plans and inhalers. Blood pressure care looks at your whole heart risk, and iron infusions help when tablets have not restored low iron.

Between reviews

Phone consultations suit some follow-up, but you need at least one face-to-face visit a year to stay eligible. Several GPs list chronic disease management among their interests on Our Team. For crushing chest pain or severe breathlessness, call 000.

Common questions