Your GP is an important member of your healthcare team when you have DCIS, early breast cancer, or are living with metastatic breast cancer.

You can access several plans through your GP to help manage your physical and mental health needs. We explain these plans and what they cover.

GPs can also:

• clarify information from your specialists if you do not understand it
• help with decisions about treatment
• suggest options for emotional and practical support
• arrange urgent appointments with a breast cancer specialist
•  help with follow-up care after treatment finishes.

Not all the symptoms you experience will relate to your cancer diagnosis. Your GP can still provide general healthcare and assess each problem. 

Chronic disease management plan

Both early breast cancer and metastatic breast cancer are ‘chronic medical conditions’. This means they are likely to be present for 6 months or longer. A chronic disease management plan helps manage your complex care needs.

1. GP Management Plan (GPMP)

A GP Management Plan can help you by providing an organised approach to your medical care. It is an action plan that you and your GP agree to that: 

• identifies your health care needs
• explains the services your GP will provide
• contains any other health care and community services you may need to help manage your condition
• lists the actions you can take to help manage your condition
• says how the plan will be reviewed down the track.

2. Team Care Arrangements (TCAs)

A TCA gives you access to other healthcare providers who may be able to provide treatment or services to you. These include ‘allied’ health professionals such as:

• physiotherapists
• registered lymphoedema practitioners
• dietitians
• podiatrists
• occupational therapists
• exercise physiologists.

With a TCA, you may be eligible for Medicare rebates for care from these health workers (up to five visits per year). This care must relate directly to your breast cancer or other chronic condition.

To have a TCA, you need ongoing treatment from your GP and at least two other healthcare providers. Your GP will need to collaborate with these providers.

Mental health plan for counselling support

Your GP can give you a mental health plan and refer you to an appropriate specialist for counselling.

With this plan, each year (January to December) you can access:

• up to 10 individual Medicare-subsidised appointments
• 10 group appointments.

These are with an allied health mental health service provider such as:

• a clinical psychologist
• specialist GP
• a mental health social worker
• a mental health occupational therapist. 

The plan also covers some other services these health providers offer, such as meditation and mindfulness.

Usually after 6 appointments, your mental health care provider asks your GP for a review. Your GP may then refer you for the remaining 4 appointments you are eligible for under this plan. They will consider:

•  a written report from the mental health professional
• whether you feel the counselling service is meeting your goals.

Anyone in your family who feels they could benefit from counselling can talk to their GP about a Mental Health Treatment Plan.

Who can access your mental health treatment plan

Your GP keeps a copy of your plan in your medical file and gives you a copy. If you give permission, they can give the plan to other people involved in your care. Tell you GP if there is any information you don't want your other health care providers to know about.

When your GP arranges a mental health care plan, the Medicare item number is different from a regular appointment. This will mean Medicare has a record that you have seen a doctor about a mental health concern. Medicare cannot give this information to anyone without your permission, except in very specific situations.

If you are concerned about how this may affect you, talk to your GP. 

When to review your plans

You should review your plan with your GP every four to six months. You can also talk to the practice nurses at your GP clinic between visits if you have any queries. The nurses may be able to help book your allied health appointments.

The cost to see health professionals

Even with a plan from your GP, the Medicare rebate may not cover the whole cost of the service provider’s treatment.

If the provider accepts the Medicare benefit as full payment, you will not have any out-of-pocket costs.

But if their fee is higher than the Medicare rebate, you will need to pay the difference (the ‘gap’). You can ask the service provider if there will be an out-of-pocket cost to you.

If it is too expensive for you, ask if they can reduce their fee. You can also ask your GP to refer you to another provider whose fees are lower.

How to find a GP

It’s important to have a GP you are comfortable with. They can make a big difference to your care.

If you don’t already have a GP, try to establish a relationship with one soon after your diagnosis.

To find or change GPs:

• ask for recommendations: talk to your family and friends or people who live near you about who might suit your needs.
• ask other health professionals: local pharmacists or members of your treating team may have suggestions.
• search the Healthdirect Australia website for GPs and other health professionals.

A good GP will see you when you need to be seen and visit you at home if necessary.

Before you book an appointment for a plan

When you book an appointment to discuss any of these plans, it is important to:

• see your regular GP (the one who has provided the most care over the past 12 months and who will provide the most care to you in the next 12 months)
• ask for a long appointment, because these plans need a discussion longer than a standard appointment
• let staff know if the appointment is for a GP Management Plan (GPMP) or Team Care Arrangement (TCA). In some clinics, a practice nurse may speak to you first to collect the information they need. You need to have the names of any allied health professionals you already see, so that they can be added to your TCA. This may allow you to receive a Medicare rebate for appointments with them.