Navigating your way through the variety of funding options can be confusing! To help you, we have put together a summary table below to make sense of it all.

 

 

If you have any questions, one of our friendly staff will be happy to help you. Contact admin@speechbee.com.au and our funding specialists will contact you to discuss the best funding options for your circumstance.

Medicare Chronic Disease Management Plan (CDM plan)

formerly known as an EPC plan.

WHO IS ELIGIBLE?

Individuals of all ages with an ongoing condition which requires care from their GP and two other health professionals.

HOW TO APPLY

Speak to your GP.

WHAT IS INCLUDED

Medicare will provide you with rebates of $52.95 for up to 5 sessions per calendar year.

HOW FUNDING IS USED

You will pay for the service in full. The rebate can then be:

1-Processed in the clinic and $52.95 placed directly back into your account

Or

2-You will be provided with a receipt for your payment which you can then use to access your rebate via Medicare’s online services or by visiting a Medicare branch.

Medicare Follow up services for Aboriginal & Torres Straight Islanders

WHO IS ELIGIBLE?

Individuals of Aboriginal and Torres Strait Islander descent are eligible for an additional 5 sessions per calendar year in addition to a CDM plan (see above).  Therefore, a total of 10 sessions with Medicare rebates can be accessed per calendar year.

HOW TO APPLY

Speak to your GP.

WHAT IS INCLUDED

Medicare will provide you with rebates of $52.95 for an additional 5 sessions per calendar year following the completion of a CDM plan.

HOW FUNDING IS USED

You will pay for the service in full. The rebate can then be:

1-Processed in the clinic and $52.95 placed directly back into your account

Or

2-You will be provided with a receipt for your payment which you can then use to access your rebate via Medicare’s online services or by visiting a Medicare branch.

Centrelink Carers Allowance

WHO IS ELIGIBLE?

Parents/carers who provide additional daily care for a child with a disability or medical condition under 16 years of age. For further information regarding eligibility see here.

HOW TO APPLY

Visit the Human Services Website here

 

If you fit the eligibility criteria for carers allowance:

  1. Read the conditions for claiming
  2. Register an intent to claim
  3. Complete the claim form
  4. Provide supporting documentation
  5. Submit your claim

WHAT IS INCLUDED

A fortnightly payment of $123.50 or a health care card for the child.

HOW FUNDING IS USED

You will receive your payment on a fortnightly basis. You can then use this payment towards accessing relevant health services including Speech Pathology.

Better Start (Dept. Human Services – Medicare)

WHO IS ELIGIBLE?

Individuals under 13 years of age with an eligible disability. Eligible disabilities include:

  • Cerebral palsy
  • Deaf blindness
  • Down syndrome, including mosaic Down syndrome
  • Fragile X syndrome with full mutation
  • Hearing impairment
  • Sight impairment
  • Prader-Willi syndrome
  • Williams syndrome
  • Angelman syndrome
  • Kabuki syndrome
  • Smith-Magenis syndrome
  • CHARGE syndrome
  • Cornelia de Lange syndrome
  • Rett’s Disorder
  • Cri du Chat syndrome; or
  • Microcephaly

HOW TO APPLY

Referrals under Medicare’s Better Start are provided by GPs, Specialists and Consultant Physicians.

WHAT IS INCLUDED

Up to 4 allied health assessment sessions (must be used by 13th birthday) and up to 20 allied health treatment services (must be used by 15th birthday).

HOW FUNDING IS USED

You will pay for the service in full. The rebate can then be:

1-Processed in the clinic and $74.80 placed directly back into your account

Or

2-You will be provided with a receipt for your payment which you can then use to access your rebate via Medicare’s online services or by visiting a Medicare branch.

Better Start (Dept. Social Services)

WHO IS ELIGIBLE?

Children under 6 years of age with an eligible disability. Eligible disabilities include:

  • Cerebral palsy
  • Deaf blindness
  • Down syndrome, including mosaic Down syndrome
  • Fragile X syndrome with full mutation
  • Hearing impairment
  • Sight impairment
  • Prader-Willi syndrome
  • Williams syndrome
  • Angelman syndrome
  • Kabuki syndrome
  • Smith-Magenis syndrome
  • CHARGE syndrome
  • Cornelia de Lange syndrome
  • Rett’s Disorder
  • Cri du Chat syndrome; or
  • Microcephaly

HOW TO APPLY

Phone the registration and information service 1800 242 636. Children with an eligible diagnosis must be registered before their 6th birthday. Children have up until their 7th birthday to use funding.

WHAT IS INCLUDED

Up to $12000 in funding to be used for funding early intervention services including Speech Pathology.

HOW FUNDING IS USED

You will not be required to pay anything on the day of the service. Your Speech Pathologist will access your funding through a secure online portal to claim payments for the Speech Pathology sessions that you attend. Funds will then be deposited into your Speech Pathologist’s account.

Helping Children with Autism (HCWA) (Dept. Human Services – Medicare)

WHO IS ELIGIBLE?

Individuals under 13 years of age with an eligible diagnosis. Eligible diagnosis include:

  • autism
  • autism spectrum disorder (ASD)
  • autistic disorder
  • Asperger’s disorder
  • childhood disintegrative disorder
  • pervasive developmental disorder – not otherwise specified (PDD-NOS)

HOW TO APPLY

Referrals under Medicare’s HCWA are provided by GPs, Specialists and Consultant Physicians.

WHAT IS INCLUDED

Up to 4 allied health assessment sessions and up to 20 allied health treatment services.

HOW FUNDING IS USED

You will pay for the service in full. The rebate can then be:

1-Processed in the clinic and $74.80 placed directly back into your account

Or

2-You will be provided with a receipt for your payment which you can then use to access your rebate via Medicare’s online services or by visiting a Medicare branch.

Helping Children with Autism (HCWA) (Dept. Social Services)

WHO IS ELIGIBLE?

Children aged 0-6 years with an eligible diagnosis. Eligible diagnosis includes:

  • autism
  • autism spectrum disorder (ASD)
  • autistic disorder
  • Asperger’s disorder
  • childhood disintegrative disorder
  • pervasive developmental disorder – not otherwise specified (PDD-NOS)

HOW TO APPLY

To access HCWA funding, children must be diagnosed and seen by an autism advisor by their 6th birthday. In NSW, contact Aspect Autism Advisers 1300 978 611 or (02) 8977 8345.

WHAT IS INCLUDED

Up to $12000 in funding to be used for funding early intervention services including Speech Pathology.

HOW FUNDING IS USED

You will not be required to pay anything on the day of the service. Your Speech Pathologist will access your funding through a secure online portal to claim payments for the Speech Pathology sessions that you attend. Funds will then be deposited into your Speech Pathologist’s account.

Department of Veteran Affairs (DVA)

WHO IS ELIGIBLE?

Australian veterans, veteran’s widows/widowers and dependants are eligible for a DVA health card.

 

Some British, Commonwealth and Allied veterans who served in conflicts in which Australia was involved may also be eligible for pensions/or benefits from DVA.

HOW TO APPLY

For enquiries, and to get a DVA card call the DVA Health Provider Line on 1300 550 457 (Metro) or 1800 550 457 (Non Metro)

 

DVA health card holders must be referred to a Speech Pathologist who is able to provide services under the Medicare Benefits Scheme.

 

A referral can be issued by a:

 

  • Local Medical Officer (LMO)
  • General Practitioner
  • medical specialist
  • treating doctor in hospital
  • hospital discharge planner
  • Speech Pathologist with a current referral.

WHAT IS INCLUDED

DVA will cover the full cost of the Speech Pathology service.

HOW FUNDING IS USED

You will not be required to pay anything on the day of the service. The Speech Pathologist will bill DVA directly for Speech Pathology sessions that you attend.

Private Health insurance

WHO IS ELIGIBLE?

Individuals of all ages who are registered with a private health fund.

HOW TO APPLY

Must be a member of a private health fund e.g. Bupa, HCF, Medibank etc.

WHAT IS INCLUDED

Speech Pathology Services are covered under certain health funds. The rebate provided varies dependent on your level of cover. Speak to your private health insurer to determine if you are covered for Speech Pathology services and the rebate amount you can expect to receive.

HOW FUNDING IS USED

1-Your private health card will be swiped at payment. If there is a gap between your private health cover and the cost of the session, you can pay the gap using eftpos/credit card. (On the spot private health fund rebates currently available at our Newington practice only).

Or

2-You will pay for the session in full. You will be provided with a receipt which you can then use to access your private health rebate (using your health fund’s website/app/relevant claims service).

Speech Bee strives to provide our website viewers with accurate and up to date information. The information stated on this page is correct- to the best of our knowledge-as of January 2017. This information is subject to change at the governments discretion, therefore it is always advised that you confirm the above information with the appropriate funding provider. 

Speech Pathology Australia Certified Practicing Speech Pathologist