Rural health

Information for patients

The following information provides an overview of the VPTAS. More detailed information about eligibility and the coverage of the scheme can be found in the VPTAS Guidelines.

Victorian Patient Transport Assistance Scheme: Guidelines, July 2009 (575kb, pdf)

Eligibility

To be eligible for assistance patients must meet all of the following criteria:

• be a Victorian resident
• live in a Department of Health designated rural region (see the DH Map of Rural Regions (626kb, pdf) to determine if you are in an eligible local government area)
• be receiving specialist medical treatment under specialty treatment codes 001-099, 102 or 115 from an approved medical specialist service registered with Medicare Australia. resources. View the list of medical specialist treatment codes that are eligible under VPTAS, and
• need to travel more than 100 kilometres one way or on average 500 kilometres per week for a minimum of five consecutive weeks.

Assistance may also be provided to metropolitan and rural Victorian residents who are referred to an interstate approved medical specialist service when the service is not available within Victoria or if this is the nearest location. The approved medical specialist must confirm in writing that the required service cannot be provided in Victoria.

Most appropriate medical specialist

In making referrals, GPs are expected to take into consideration the specific medical needs of the patient and minimise the travel required by referring to the nearest approved medical specialist service.

If the patient meets all other VPTAS criteria but decides to travel beyond the nearest specialist, payment will be made at the appropriate rate of travelling to the nearest approved medical specialist only.

Non-concession card holders

Patients who are not the primary card holder of an approved Pensioner Concession Card or Health Care Card will pay the first $100 each treatment year. Once the $100 payment has been made patients will receive full VPTAS assistance for the remainder of that treatment year. A treatment year is defined as 12 months from the date of the patient's first listed medical specialist service.

Assistance for an escort

An approved patient escort may also be eligible to seek assistance for travel and accommodation costs. An escort is responsible for the patient's transport and accommodation needs during treatment.

An approved escort must be:

• 18 years of age or older
• accompanying the patient whilst travelling and
• deemed necessary by the approved specialist.

Assistance provided

Patients, and approved escorts may be eligible for both travel and accommodation assistance.

Travel assistance includes:

• subsidies for private car travel - a reimbursement of 17 cents per kilometre is paid where a private vehicle is used;
• full concession fare reimbursements for public transport
• air travel only if the journey exceeds 350 kilometres one way and a commercial flight is used
• taxi travel only to the nearest public transport and only when a patient has no other means of transport available.

Patients will only be able to claim assistance for travel directly between a patients residence and their medical specialist treatment on the initial trip (via accommodation if applicable) and the return trip. Any travel during a treatment episode is not covered under VPTAS.

Accommodation assistance is paid at a maximum of $35.00 per night, plus Goods and Services Tax (GST) for a patient and an approved escort staying in commercial accommodation. Commercial accommodation is accommodation that is registered as a business and has an Australian Business Number (ABN). Accommodation allowance is only available if the patient and an approved escort (if applicable) are eligible for travel assistance.

The approved medical specialist or authorised officer must specify on the claim form the number of nights accommodation is required in connection with the treatment, and must also approve the need of an escort.

Determining whether distance criteria is met

To consistently and accurately calculate the most direct surface route between the patients permanent residence and the approved medical specialist service, the department uses the 'route planner system'.

Route planner

The route planner is used to measure the kilometre distance between the patient's permanent residential address and the address of the medical specialist service by the most direct and simplest route. The simplest route calculates distance based on major highways and roads.

No deviations from the simplest direct route are considered in measuring the distance.

The level of subsidy received by a patient is based on distance calculated by the route planner.

Use the route planner to determine how far you have travelled.

Completing a claim form

To apply for VPTAS, all patients are required to complete a VPTAS Claim Form. The form requires the details of the approved medical specialist services to be verified by the approved medical specialist or an authorised representative. The specialist or authorised representative must also endorse the need for accommodation and the need for an escort.

 Victorian Patient Transport Assistance Scheme (VPTAS) Claim Form

Patients have the option of submitting a form for a single trip, or multiple trips. Each claim form has space for up to six trips on the travel and accommodation diary which is included in the form.

In situations where patients have undertaken more than six trips, the travel and accommodation diary can be submitted with a claim form. These must also be signed by the approved medical specialist or authorised representative on or after the trips which are being claimed.

Victorian Patient Transport Assistance Scheme: Travel and Accommodation Diary (blank) (114kb, pdf)

A checklist and an example travel and accommodation diary has been prepared to provide additional help in completing a claim form.

Making a claim

Completed VPTAS forms must be submitted no later than 12 months from the date of the first listed approved medical specialist service. Original receipts for travel and accommodation need to be submitted with your claim form. Petrol receipts are not required. The lodgement date is the date the Victorian VPTAS Office receives the completed claim form.

Assessment process

Claims are assessed by the Victorian VPTAS Office. Completed claim forms should be sent to the Victorian VPTAS Office.
If a VPTAS claim form is incomplete or documentation is missing, the Victorian VPTAS Office will contact the patient to advise of sections to be completed and any documentation required for the claim to be assessed.

It takes approximately 6-8 weeks to process a claim. Patients will be notified in writing if their claim is unsuccessful. The

Victorian VPTAS Office will advise why the claim was unsuccessful.

Review process

In cases where the Victorian VPTAS Office declines part or all of a VPTAS claim, patients have three months from the date of notification to write to the VPTAS Review Manager requesting a review of the decision.

Patients must write to the VPTAS Review Manager and send the request to the Victorian VPTAS office.

Further information about the VPTAS scheme can be found in the VPTAS Guidelines.