Facts about reimbursement of your catheters

Facts about reimbursement of your catheters

Learn about common terms and coverage types

Your rights to funding

You may be eligible for funding for your continence products and it is important to know your rights. The Australian Government, the New Zealand Government and State and Territory Governments offer a number of subsidy schemes that can help offset some of the costs of your continence products. Below is a summary of these schemes.

Australia    Victoria    New South Wales    Queensland    South Australia

Western Australia    Tasmania    Northern Territory    ACT    New Zealand

NDIS

The National Disability Insurance Scheme (NDIS) launched in 2013 following years of discussion about the need for a major reform of disability services in Australia.

Eligibility

  • The scheme supports people with a permanent disability that prevents them from taking part in everyday activities.
  • Under 65 years old
  • Australian residency (or special category visa)
  • The NDIS is being rolled out to different regions in stages from July 2016. It is expected that the scheme will be available nationally by the end of 2019.

For more information, call our dedicated team on 1800 880 427.

Visit our dedicated NDIS page

CAPS

The Continence Aids Payment Scheme is an Australian Government scheme that assists eligible people who have permanent and severe incontinence to meet some of the costs of continence related products.

Eligibility

  • People 5 and over
  • Application form requires a report from an appropriate Healthcare Professional
  • Not accessing NDIS or DVA assistance
  • For further eligibility criteria, speak to your Health Care Proffessional

How much funding is available?
The CAPS payment for 2016-17 is up to $572.30 and is indexed annually.

Where can I get more information?
Visit the CAPS website

DVA Rehabilitation Appliances Program

The Department of Veterans’ Affairs (DVA) provides a range of continence products to eligible members of the veteran community through the Rehabilitation Appliances Program (RAP).

Where can I get more information?
Visit the DVA website

Victorian schemes

State-wide Equipment Program (SWEP)

SWEP provides Victorian people who either have a permanent or long-term disability (and not accessing NDIS) or are frail aged with subsidised equipment including a wide variety of continence aids to enhance their independence and facilitate community participation. A yearly assessment and new script by a registered SWEP continence nurse advisor is required for continued eligibility. The State-wide Equipment Program is managed by Ballarat Health Services.

Where can I get more information?
Visit the SWEP website

Traffic Accident Commission (TAC)

The TAC pays benefits for the reasonable cost of medical treatment, rehabilitation services, disability services, travel and household support services that are needed as a result of injuries incurred in a traffic accident. Benefits are paid from a subsidy applied to vehicle registrations in Victoria. The scheme is run by the Victorian state government. An assessment and new script by a continence nurse advisor is required every 2 years for continued eligibility.

Where can I get more information?
Visit the TAC website

NSW schemes

EnableNSW

EnableNSW provides aids and equipment such as wheelchairs, ventilators, prosthetic limbs and continence products for people living with disability or chronic health conditions that are not accessing NDIS.

Eligibility

  • Permanent or long-term disability
  • People with a Health Care Card or Pensioner Concession Card
  • Not receiving assistance from other schemes
  • Needs not covered by CAPS payment

Where can I get more information?
Visit the EnableNSW website

Lifetime Care and Support Scheme (icare)

The Lifetime Care and Support Scheme provides people who have been severely injured in motor accidents in NSW with treatment, rehabilitation and care, regardless of who was at fault in the accident. The scheme is funded by a levy on NSW green slips (compulsory third party insurance).
The scheme pays for services related to the motor accident injury that are considered ‘reasonable and necessary’ including medical treatment, rehabilitation, aids and equipment, home and vehicle modifications, attendant care services and help to return to study or work.

Where can I get more information?
Visit the icare website

Queensland schemes

Medical Aids Subsidy Scheme (MASS)

MASS subsidy funding for medical aids and equipment (including those for continence management) is available to eligible Queenslanders with permanent/stable conditions or disabilities. Aids and equipment are subsidy funded either on a permanent loan basis, private ownership or through the supply of consumables.

Eligibility

  • Aged over 5 years who have a disability and live in Queensland
  • Not accessing other funds such as NDIS, DVA, WorkCover or compensation (clients may receive MASS in addition to CAPS)
  • Holders of a relevant Pensioner Concession Card or Health Care Card

Where can I get more information?
Visit the QLD Government website

National Injury Insurance Scheme (NIIS) Queensland

Starting 1 July 2016, the NIIS Queensland provides people who sustain serious personal injuries in a motor vehicle accident in Queensland with necessary and reasonable lifetime treatment, care and support.

The scheme is administered by the National Injury Agency Queensland and helps participants achieve their individual goals, maximise their independence and participate in the community.

Where can I get more information?
Visit the NIIS Queensland website

Other state based schemes

South Australia - Department of Social Inclusion (DCSI)

The Department for Communities and Social Inclusion (DCSI) is able to provide some assistance for continence products to eligible clients registered with Disability SA and Disability Services. To obtain assistance the client must have spent their CAPS allowance for the year.

Where can I get more information?
Visit the SA Government website

Western Australia - Continence Management and Support Scheme (CMASS)

The Silver Chain Nursing Association delivers the Continence Management and Advice Service at clinics through Western Australia. Specialist nurses provide assessment and advice on how to best manage and improve your bladder or bowel condition. If continence products are required, Silver Chain can assist with accessing a subsidy of up to $490 per year through Independence Australia.

Where can I get more information?
Visit the WA Government website

Tasmania - Community Equipment Scheme (CES)

The Tasmanian Department of Health and Human Services operates the Community Equipment Scheme (CES). Continence supplies (available from Independence Australia) of up to $1000 per year are available for eligible clients who pay half the costs of supplies received. People who are eligible for CAPS or DVA continence assistance will not be eligible for this scheme.

Where can I get more information?
Visit the Tasmanian Government website

Northern Territory - Disability Equipment Program (DEP)

Operated by the Northern Territory Department of Health, the Disability Equipment Program (DEP) (formerly the Territory Independence and Mobility Equipment scheme) aims to provide prescribed equipment, aids and appliances to assist with safety, independence and participation in the community.

Where can I get more information?
Visit the NT Government website

ACT Equipment Scheme

Provides funding to assist people with long-term disabilities who are over 65 years old to obtain and maintain a range of equipment to assist them to live at home. Access to the ACT Equipment Scheme is via Health professional referral. If the continence issue is due to a permanent disability and you are under 65, please contact the NDIS.

Where can I get more information?
Visit the ACT Government website

New Zealand

Ministry of Health

If it has been assessed that you need to use catheters, you may be eligible for funding from the Ministry of Health. Once your Specialist has decided what products you need, they will refer you to your local District Health Board to provide funding for your allocated products.

Where can I get more information?
For more information, please speak to your healthcare professional.

For a list of Service Providers available visit Continence NZ.

ACC

The Accident Compensation Corporation (ACC) provides no-fault personal injury cover for all New Zealand residents and visitors to New Zealand. For ACC clients all continence needs are assessed by a specialist continence nurse or Spinal Unit Nurse contracted by ACC. The ACC case manager will make the decision on what services will be funded based on the nurse’s assessment. Treatment depends on what is required and may be delivered by the public system in some acute circumstances or other services as contracted by ACC. Prescribed products are then provided directly to the client’s home by a contracted supplier to ACC.

If your workplace is under a partnership agreement, your claim may be handled by WellNZ. This will change the application process which your Healthcare Professional will help you with.

Where can I get more information?
Visit the ACC website

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