How to claim for pharmacogenetic testing

There's no waiting period on Mental Health Support, so no need to serve waiting periods.

Benefits will be paid towards pharmacogenetic testing for all conditions (not just mental health related conditions) where it is administered in person, or for approved home kits where supporting documentation from a medical practitioner outlining the clinical purpose is supplied.

Claims for tests completed in person (PGXLAB) are accepted from any recognised pathology provider, including hospital pathology departments. No referral letter is required as the account itself may be taken to be an appropriate referral.

Claims for tests completed at home (PGXKIT) are payable where a GP referral has been provided stating there was a clinical need. Benefits will only be paid for Pharmacogenetic testing completed at home, where the kit has been purchased from an approved provider.

A letter of referral is valid for 12 months from the date of issue, unless otherwise indicated on the referral i.e. the claim service date must occur within 12 months - or within the timeframe indicated on the letter of referral, of the letter of referral start date. 

For the purposes of claiming, it is preferred that a referral is obtained prior to or at the same time as the supply of the relevant item, however Medibank will accept claims where the date of the referral is up to 30 days post supply / purchase of the item / date of service.