More than 400 community members have written to Macular Disease Foundation Australia (MDFA) supporting its call for the Government to delay planned changes to the Medicare Benefits Schedule (MBS), that would prevent the use of private health insurance to cover the cost of eye injections in private day hospitals and surgeries.

Changes to the MBS items for eye injections – planned to come into effect on 1 July 2026 – could affect more than 12,200 people by increasing out-of-pocket costs for eye injections in the private system. And MDFA fears that this will lead to people ceasing treatment.

MDFA CEO, Dr Kathy Chapman said the letters, which have been shared with Federal Health Minister Mark Butler’s office, tell deeply personal stories about the financial strain anticipated by the Government’s planned changes.

“My husband and I are age pensioners and have no other source of income,” wrote one person. “I am my husband’s carer, as he has two life-threatening medical conditions. I rely on my private health fund to pay for my eye injections and would not have the means to continue injections if discontinued.”

Another correspondent shared a similar concern: “I am no longer working due to spinal degradation and would not be able to afford my eye injections without private health insurance.”

A third writer highlighted the challenge of balancing family and health costs. “As a single parent, I struggle to afford rising health insurance premiums as it is. To not have the coverage for my eye injections in hospital would be a detriment to my long-term health as a 53-year-old with an eye condition.”

“Reading these letters was incredibly moving,” said Dr Chapman. “People shared their fears about no longer being able to afford their treatment and losing their sight as a consequence – how this would impact their quality of life and independence.

“Delivering these concerns to Canberra was about making sure these voices were heard at the highest level,” she added.

EQUITABLE ACCESS AHEAD OF CHANGE

Dr Chapman said the planned change to MBS items should be delayed until broader reforms guarantee equitable access to affordable treatment nationwide – including more outpatient eye injection services in public hospitals.

A recent MDFA project found that only 40 of the 286 public hospitals investigated delivered outpatient eye injection services. More than half of the public hospitals (23 hospitals) found to provide eye injection treatment services were located in metropolitan areas, with fewer services (17 hospitals) found in rural, regional, and remote areas.

Additionally, MDFA’s social impact research found that the (self-reported) median total annual cost of living with a macular disease is AU$3,621 per person. This is 12% of the annual Age Pension rate for a single person. And with 2023 MBS data showing that only 28% of all people who received eye injections in-rooms across Australia were bulk billed, removing the use of private health insurance to cover the cost of eye injections in day surgeries will result in even more people having to pay out-of-pocket costs for treatment.

Regardless of the government’s decision on the proposed MBS changes, Dr Chapman said MDFA would continue its advocacy efforts.

“For 25 years, we’ve worked with government and eye health professionals to drive systemic change and champion quality of life for Australians with macular conditions, and we’ll continue fighting to ensure sight-saving treatments and support remain accessible and affordable.”

To read MDFA’s full recommendations and stay updated on this issue, visit mdfoundation.com.au/eye-injection-typec-change.