PSS eligibility criteria and mandatory requirements?
The Premium Support Scheme (PSS) is an Australian Government scheme designed to help eligible doctors with the costs of their medical indemnity insurance. MIPS administers this scheme on behalf of the Government. Eligible doctors will see the benefit of the PSS as a reduction in the total membership fee payable. You may be eligible for the PSS if:
- your gross medical indemnity costs exceed 7.5% of your estimated gross income generated from private billings; or
- you are a procedural general practitioner in a rural area; or
- you have retired from private practice ($0 private medical income for the full membership period), but continue to practice in the public sector and your medical indemnity costs include run-off cover for incidents relating to prior periods of private practice.
Gross private medical income: The total of all billings generated by an eligible doctor from all areas of their practice for which they require medical indemnity cover for a premium period (in their name or for work for which they are personally liable, including Medicare benefits, payments by individuals, and payments by the Commonwealth department of Veterans’ Affairs, worker compensation schemes and third party and/or vehicle insurers) whether retained by the doctor or otherwise and before any apportionment or deduction of any expenses and/or tax. If as part of the doctor’s medical practice, they derive income from any other sources (ie professional fees, incentive payments, etc) this income must be included in the declaration of gross private medical income.
Subsidy address: If you practice at more than one location please provide details of the practice address where you generate the majority of your private fees or if you are a procedural general practitioner select the practice address which is located in a rural or remote area. If you have retired from private practice you are required to state the last subsidy address where you previously undertook that private practice.
Provider number: Your provider number must relate to the subsidy address stated above.
Maintaining PSS eligibility
If you are advanced a PSS subsidy, it is a Medicare Australia mandatory requirement that you complete and return to MIPS a Final Determination form verifying your “actual gross private medical income” within 12 months of the completion of the subsidy period. If you do not return this form by the due date you will be requested to repay the full amount of PSS subsidy advanced to you.
PSS details will be outlined in your Member Benefit Statement (tax invoice). For more information, please visit the Department of Health website and refer to the PSS Frequently Asked questions at health.gov.au