Therapy Funding

Private Health Funds

Please contact your own Private Health Fund to find out if Occupational Therapy is covered by your policy and confirm the amount of cover and the yearly allowance. It is unlikely that your Private Health will cover the full amount and therefore there will be a gap payment to pay.

Medicare –Enhanced Primary Care Plans / Chronic Disease Management Plan

An EPC or CDM plan provides a total of five Allied Health services per patient each calendar year

Patient must have an Enhance Primary Care (EPC) / Chronic Disease Management plan prepared by their GP and this must be provided at the first session.

The G.P makes the decision as to whether the child is deemed to have a chronic medical condition.

The sessions can be divided between different Allied Health Services / therapies.

Sessions are paid for in full and then a rebate can be issued via HICAPS or by taking your receipt to Medicare or claiming through the app to obtain a refund.

http://www.health.gov.au/internet/main/publishing.nsf/content/health-medicare-health_pro-gp-pdf-allied-cnt.htm

Mental Health Care Plan

Medicare rebates are available under the Better Access to Mental health initiative. The number of sessions available per Calendar year is 10. These sessions should be provide in 2 sets of 5 sessions, with a review by the referring practitioner after the first group of sessions

Rebates are available to those who have been referred by a G.P under the GP Mental Health Careplan, and / or a psychiatrist assessment and management plan.

Sessions are paid for in full and then a rebate can be issued via HICAPS or by taking your receipt to Medicare or claiming through the app to obtain a refund.

http://www.health.gov.au/mentalhealth-betteraccess

Better Start Initiative for Children with Disability (Better Start)

The Better Start Initiative provides funding support for therapies and early intervention for children with the following diagnosis

  • Cerebral Palsy
  • Down Syndrome
  • Fragile X
  • Hearing and Visual Impairments
  • Prada Willi Syndrome
  • William Syndrome
  • Angelman Syndrome

With Better Start Funding up to $12,000 ( maximum of $6,000 / year) can be accessed to help pay for interventions/ services such as Occupational Therapy, Speech Therapy, Physiotherapy etc. It can also be used to purchase resources in order to facilitate early intervention.

The child’s Doctor can assist in developing a Treatment and Management plan

Deb’s O.T services for kids is a registered Provider for Better Start.

http://www.betterstart.net.au/

FaHCSIA Autism Early Intervention Package

Deb’s O.T Services for Kids is a registered Provider for  FaHCSIA Autism Early Intervention Package.   It can be accessed to help pay for interventions/ services such as Occupational Therapy, Speech Therapy, Physiotherapy etc. It can also be used to purchase resources in order to facilitate early intervention and the child’s transition through school.

Deb’s O.T services for kids is a registered Provider for FaHCSIA Helping Children with Autism.

http://www.autism.net.au/FaHCSIA_Funding.htm

Helping Children with Autism (HCWA)

The Australian Government provides intervention for children over 6 years old, with a diagnosis of ASD. This plan allows access to services and interventions up to the age of 15 years old. A Paediatrician or Psychologist can set up this plan but it can only be accessed one time by a child. It can include up to 20 Allied Health sessions.

Deb’s O.T services for kids is a registered Provider for Helping Children with Autism.

https://www.dss.gov.au/our-responsibilities/disability-and-carers/program-services/for-people-with-disability/early-intervention-services-for-children-with-disability

If you are planning to use any of these funding options they will need to be confirmed and pre-arranged before commencing. For example, confirming with your Private Health care fund that you are covered for Occupational therapy, or providing a copy of your EPC or MHP for you G.P or a copy of your “letter of Introduction” from Autism Queensland to access the Fahcsia funding.

The National Disability Insurance Scheme (NDIS)

The government is gradually introducing the NDIS as a new way of supporting people with disabilities in an individualised and lifelong approach through community linkages and individualised funding plans. Both HCWA and Better Start have been identified for transition to the NDIS in the future.

If you are planning to use any of these funding options they will need to be confirmed and pre-arranged before commencing. For example, confirming with your Private Health care fund the you are covered for Occupational therapy, or providing a copy of your EPC or MHP for you G.P or a copy of your “letter of Introduction” from Autism Queensland to access the Fahcsia funding.

Helpful links

Autism Queensland – https://autismqld.com.au/

Carer’s QLD – Carer’s QLD

NDIS – http://www.ndis.gov.au/

HCWA / Better Start – http://www.betterstart.net.au/

FAHCSIA – HELPING CHILDREN WITH AUTISM PACKAGE – http://www.autism.net.au/FaHCSIA_Funding.htm

Early Intervention Services for Children with Disability  – https://www.dss.gov.au/our-responsibilities/disability-and-carers/program-services/for-people-with-disability/early-intervention-services-for-children-with-disability

Better Access to Mental Health – http://www.health.gov.au/mentalhealth-betteraccess

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