Commonwealth Consolidated Acts

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HEALTH INSURANCE ACT 1973 - SECT 14

Medicare benefit not to exceed medical expenses incurred

             (1)  A medicare benefit payable in respect of a professional service shall not exceed the medical expenses incurred in respect of the professional service.

             (2)  Subsection (1) does not apply if:

                     (a)  the rendering of the professional service is covered by an agreement between a private health insurer and another person; and

                     (b)  the amount payable under the agreement for the professional service is not determined on a fee for service basis.



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