NDIS and funding - children

Medicare and other funding

Medicare and other funding

In an ideal world, assessment and diagnosis would be rapid, professional and free.

There are many state-funded services which do provide diagnosis and some people are able access these without a long wait and without having to travel too far.

However, most state-funded assessment services have very long waiting lists and families can be left waiting for up to 12 months for an appointment. You may need or choose to use private professionals to do an assessment of your son or daughter. There are some funding options that can help.

Your GP can refer you to a paediatrician or psychologist / psychiatrist for diagnosis, and there is a Medicare item number which can be claimed to pay for part of this cost.

The paediatrician or psychologist / psychiatrist can then give you referrals to see up to another four professionals for diagnostic services such as audiologists, occupational therapists, optometrists, physiotherapists, psychologists and speech pathologists.

For children aged 13 years or under, Medicare rebates are available to help cover at least some of the cost.
These Medicare items cover:

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Assessment and diagnosis by a paediatrician or child and adolescent psychiatrist
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Up to 4 allied health professional assessments to assist with the diagnosis
(Eligible allied include psychologists, speech pathologists, occupational therapists, audiologists, optometrists or physiotherapists)

Better Access to Mental Health Care Scheme

The scheme is available to all Australians and we highly recommend you use it for anyone in your family or care where required. In particular if you are experiencing anxiety, depression or emotional strain it can be a huge help.

Many children, teenagers and adults on the autism spectrum take advantage of this program to help fund visits to a psychologist. Many parents and carers also access the scheme and find it very beneficial.

Under the scheme Medicare rebates are available to patients for selected mental health services provided by general practitioners (GPs), psychiatrists, psychologists (clinical and registered) and eligible social workers and occupational therapists.

Medicare rebates are available for up to ten individual and ten group allied mental health services per calendar year to patients with an assessed mental disorder who are referred by:

  • A GP managing the patient under a GP Mental Health Treatment Plan; or
  • Under a referred psychiatrist assessment and management plan; or
  • A psychiatrist or paediatrician

The first step to access the scheme is to see your GP who will assess whether you have a mental disorder and whether the preparation of a GP Mental Health Treatment Plan is appropriate for you.

Chronic Disease Management Plan

Again this scheme is available to all Australians and is a means to access additional services for both people on the spectrum and their parents or carers.

A chronic medical condition is one that has been present for six months or longer. In the area of ASD the most common examples include: anxiety, depression or stress (PTSD). There is no list of eligible conditions. However, these items are designed for patients who require a structured approach to their care and to enable GPs to plan and coordinate the care of patients with complex conditions requiring ongoing care from a multidisciplinary team.

For more information:

Getting started

Access to all of these Medicare rebates starts with a visit to your GP. It is invaluable to find a GP who understands autism spectrum disorder and who is across all the different Medicare rebates that can be accessed.

Not all GP’s will be well versed in this area so it’s important to make sure you do your research and be well informed before you go see your GP.


Carer Allowance

This is a Centrelink payment for carers who provide additional daily care and attention for someone with a disability.

If you are providing care to someone who is aged 16 or older:

  • Carer Allowance is $131.90 each fortnight

If you are providing care to a child aged under 16 years Carer Allowance is either:

  • For a child with higher needs – $131.90 every fortnight and a Health Care Card for the child OR
  • For a child with lower needs – a Health Care Card for the child

If you share the care of the child and the other parent is not your partner:

  • You get part of the payment
  • The other carer gets the rest, based on how much care you each provide

If you meet the Carer Allowance income test, your income doesn’t affect how much Carer Allowance you can get. This payment doesn’t add to your taxable income. Payment rates change on 1 January each year to keep up with the cost of living.

It is a good idea to apply for Carer Allowance as soon as you have decided to seek an assessment, so long as you are providing daily care for your child. The payment starts from the date the form is lodged not from the date of assessment.

To start the process visit your GP, as you and a medical practitioner both need to fill in the form.

For more information:

Health Care Card

You / your child with autism may be eligible for a Health care card if you get specific payments or supplements from Centrelink or the maximum rate of family tax benefit Part A. Check the health care card eligibility here.

A Health Care Card entitles the holder to:

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Bulk billing by your GP
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Cheaper PBS medicines
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Assistance with hearing services through
the Office of Hearing Services
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Discounted mail redirection through
Australia Post

State and Territory Governments and local
councils may offer concessions, such as:

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Energy and electricity bills
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Health-care costs, including ambulance,
dental and eye care
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Public-transport costs
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Rates
Please check with your State and Territory Government regarding which concessions are available to Health Care Card holders. Concessional entitlements may vary between States and Territories.
For more information:

Carer Payment

This is a payment made to carers who provide care for a person with a severe disability who has higher needs. The payment is means tested, and evaluated based on income, assets and residential requirements.

Payments are made fortnightly and the rate varies depending on your individual assessment.

For more information:

Annual Payments - Carer Supplement

This is an annual lump-sum payment to assist carers with the costs of caring for a person with a disability. To be eligible for the payment you must be receiving the Carer Allowance or the Carer Payment as of the 1 July each year.

The payment is approximately $600 and you do not need to apply for it. You will automatically receive it if you are eligible however it’s always a good idea to check with Centrelink.

For more information:

Annual Payments - Child Disability Assistance Payment

This is an automatic yearly payment if you are receiving the Carer Allowance for looking after a child with a disability or serious illness as of the 1 July each year.

The payment is up to $1000 for each eligible child who qualifies for the Carer Allowance. If you are getting Carer Allowance for 2 children, you will get 2 payments.
If you share the care for a child and get a part rate of Carer Allowance, you will get a part payment of the Child Disability Assistance Payment in the same ratio

For more information:

Carer Adjustment Payment

This is a one off payment to assist families following a catastrophic event where a child younger than 7 is diagnosed with a severe disability or severe medical condition.

To get this payment you must provide full time care for a child younger than 7 and meet other rules.

The most any family can get is up to $10,000 for each child for one catastrophic event.

You need to complete a form to apply for a Carer Adjustment Payment.

For more information:

Payments for people over 16 years of age

Once young people are over 16 years of age there are other funding supports available, such as the Disability Support Pension, Youth Allowance, Youth Disability Supplement and more.

For more information:

Parking

The Australian Disability Parking Scheme (ADPS) includes an Australian Disability Parking Permit, which is recognised nationally.

It establishes nationally consistent eligibility criteria and national minimum parking concessions to help reduce the barriers for permit holders when travelling interstate.

Permit holders can:

  • park in disability parking spaces that display the international symbol of access
  • receive concessions in public parking spaces where signs or metres show specific time limits

State and Territory Governments are responsible for the management of the ADPS. Most States and Territories acknowledge that individuals with an Autism Spectrum Disorder may fit the criteria for a Mobility Parking Permit where the criteria specifies being able to walk independently. A tendency to abscond and/or the inability to understand or obey road safety rules may be taken into consideration by the GP when deciding if the individual meets eligibility criteria.

Enquiries about permit applications, cost, eligibility and use, should be directed to your relevant State or Territory authority.

State-based Australian Disability Parking Scheme authorities

Find out more about Australian Disability Parking Scheme here

Respite

The Commonwealth Carer Respite Centres provide free and confidential information on local carer support, disability and community services. You can contact your nearest centre by phoning 1800 052 222 during business hours and 1800 059 059 for emergency respite support outside standard business hours.

There are also many private organisations that provide respite services and emergency respite services. They are often state based and you can find these via an internet search or by contacting your local state autism association.

Short Term Accommodation

The National Disability Insurance Scheme (NDIS) is person-centred, strengths-based and takes the perspective of the participant, therefore the concept of ‘Respite’ is reframed as ‘Short Term Accommodation’. Short Term Accommodation (STA) is about giving your child a change and a break from his or her home routines and can be a way to build capacity, foster independence and the development of relationships with people outside the family. For more information about how the NDIS can assist click here.

Continence Aids Payments Scheme (CAPS)

It can take longer for some children and teenagers with a disability to learn to go to the toilet. The Continence Aids Payment Scheme offers financial assistance to children over the age of 5 who are not yet toilet trained and require nappies.

To apply for the scheme an application form must be completed by a health professional. Payments are made either annually or biannually to eligible recipients via Medicare. Click here to read more about CAPS.

There are also state based programs that can offer assistance with the cost of continence aids. To find out more about what is available in your state visit the Continence Exchange website.

When the National Disability Insurance Scheme (NDIS) rolls out in your area, it should fund reasonable and necessary continence supports for your child with ASD. Be sure to provide supporting documentation that outlines your child’s continence support needs for NDIS planning meetings. For more information about NDIS supports click here.

Companion Card

The National Companion Card Scheme brings together State and Territory Companion Card programs that enable eligible people with lifelong disability to participate at venues and activities without incurring the cost of a second ticket for their companion.

Although this is a national program, each state runs its own application process. You should apply for a companion card in the state in which you reside.

“I had no idea there was other funding outside of the NDIS”