There are different ways to access financial support to to cover some or all of your Occupational Therapy sessions.Your local GP or Pediatrician may be able to assist you in sourcing some of these funding.
Medicare Chronic Disease Management Plan ( Enhanced Primary Care)
Lincy is registered with Medicare and able to provide treatment under an Enhanced Primary Care plan. This scheme gives you 5 subsidised sessions for allied health therapy, including occupational therapy.
Enhanced Primary Care is for people with complex care needs and requires a referral from your child’s GP.Typically, the rebate under such a referral is $52.95 per session for a maximum of 5 sessions per calendar year. More information is available on the website www.health.gov.au/epc
Medicare – Better Start for Children with a Disability – Assessment
Item Number: 82010
For children under the age of 13 with a diagnosis of Cerebral Palsy, Down syndrome, hearing impairment, vision impairment or Fragile X syndrome and from the 1st January 2013 children with a diagnosis of Prader Willi, Williams, Angelman, Kabuki, Smith-Magenis, CHARGE, Cornelia de Lange and Cri du Chat syndromes and microcephaly will also be able to access this funding.
Four Medicare rebates for Psychologists, speech pathologists, occupational therapists, audiologists, physiotherapists, optometrists and orthoptists, on referral from a specialist, consultant physician or general practitioner, to assist the referring practitioner in the assessment, diagnosis and development of a treatment and management plan.
Medicare – Better Start for Children with a Disability – Treatment
Item Number: 82025
For children under the age of 15 (although plan must be in place by the time child turns 13 years) up to 20 rebates per lifetime for treatment with psychologists, speech pathologists, occupational therapists, audiologists, physiotherapists, optometrists and orthoptists, consistent with the treatment and management plan prepared by the referring practitioner. Referral must be provided by a GP or specialist.
Medicare – Helping Children with Autism – Assessment (82010)
For children under the age of 13 with a diagnosis of Autism Spectrum Disorder. Four Medicare rebates for Psychology, Speech Pathology or Occupational Therapy for the purpose of assessment to assist a Psychiatrist or Paediatrician with diagnosis and/or contribute to the practitioner’s treatment plan. This is a once off provision. Referral must be provided through a Psychiatrist or Paediatrician NOT a GP.
Medicare – Helping Children with Autism – Treatment(82025)
For children under the age of 15 with Autism Spectrum Disorder, total of 20 Medicare rebates (a maximum of 10 referred at a time) for Psychology, Speech Pathology or Occupational Therapy. This is a once off provision NOT yearly and a referral must be provided by a Psychiatrist or Paediatrician NOT a GP.
FaHCSIA – Helping Children with Autism – Early Intervention
Children with a formal diagnosis of an Autism Spectrum Disorder (eg. Autism, PEE, Asperger Syndrome, Rett Syndrome) who are under 6 years of age can be registered for this funding package
To be eligible for the early intervention funding package a child must have been seen by an Autism Advisor and deemed eligible to access the program before their sixth birthday. The $12,000 in funding under the early intervention component can be used until the child’s seventh birthday to a maximum of $6,000 per financial year.
Up to 35 per cent of a child’s early intervention funding may be used to purchase resources, to a maximum of $2,100 per financial year, or $4,200 in total. Resources must have been assessed by an Early Intervention Panel Provider as being integral to the child’s therapy. .
To register for the program parents must contact Autism Victoria on 9657 1608 or 1300 424 499 For more information, please contact Autism Spectrum Australia on 1300 978 611 or www.fahcsia.gov.au/autism
FaHCSIA – Better Start for Children with a Disability – Early Intervention
Children with a formal diagnosis of Cerebral Palsy, Down syndrome, hearing impairment, vision impairment, or Fragile X and from the 1st January 2013 children with a diagnosis of Prader Willi, Williams, Angelman, Kabuki, Smith-Magenis, CHARGE, Cornelia de Lange and Cri du Chat syndromes and microcephaly will also be able to access this funding.
Eligible children can be registered to access early intervention funding of up to $12,000 (up to a maximum of $6,000 in any one financial year). Eligible children must be registered before their 6th birthday and families will have until their child turns seven to use the early intervention funding. Up to 35% of a child’s early intervention funding can be used for the purchase of resources. This means that up to $4,200 in total out of the $12,000 can be used for resources, up to a total of $2,100 in any one financial year. The funding can be used to pay for early intervention services provided by a range of early intervention professionals who are members of the Better Start Early Intervention Service Provider Panel.
To register for the program parents must contact a dedicated Registration and Information Service (RIS), which is operated by Carers Australia on 1800 242 636.
Private Health Insurance:
LOTS4KIDS OT Services is a registered provider with most health insurance funds. If you will be claiming through your private health insurance, please contact your insurance company for details.