Funding

Office team are analysing graphs on the desk

Funding

National Disability Insurance Scheme (NDIS)

Word of Mouth Speech Pathology provide services to self-managed and plan-managed participants with the National Disability Insurance Scheme. We provide in home or community-based speech pathology services to eligible NDIS participants of all ages across Mudgee, Wellington and the Central West. Therapists provide standardised assessments, therapy and progress reports to submit to the NDIS for funding reviews.

The National Disability Insurance Scheme (NDIS) is the new way of providing support for Australians with disability, their families and carers.

Children and adults must first be assessed in order to see if they are eligible for funding, but may be able to access NDIS support if they meet the following criteria:

  • Have a permanent disability that significantly affects the ability to take part in everyday activities;
  • Are aged less than 65 when they first enter the NDIS;
  • Are an Australian citizen or hold a permanent visa or a Protected Special Category visa; and
  • Live in Australia where the NDIS is available.
  • They have an impairment or a condition that is likely to be permanent (ie: likely to
    be lifelong)
  • The impairment substantially reduces their ability to participate effectively in activities or perform tasks or actions unless they have assistance from others, technology, assistive equipment etc..
  • The impairment affects the child/adult’s capacity for social and economic participation
  • A child is likely to require support under NDIS for the child’s lifetime.

For more information on the NDIS, please visit https://www.ndis.gov.au or contact  them on 1800 800 110.

I Love NDIS logo

Private Health Cover

Word of Mouth Speech Pathology assessment and therapy sessions can be claimed through Private Health Insurance if you have appropriate extras cover. The rebate amount per session and the number of sessions covered is dependent on your provider and level of cover. The rebate for assessments is usually higher than that for therapy sessions. A typical rebate would be somewhere between $30-$80 per therapy session for 10-16 sessions per calendar year.

Before commencing therapy, please check with your health fund to ensure that Speech Pathology is included in your cover and the amount you are eligible to claim for each individual assessment and therapy session.  A receipt will be issued following your appointment that can then be submitted to your health fund for a rebate.

Collection of logos such as Medibank, HCF, and Bupa

Chronic Disease Management

Word of Mouth Pathology is registered with Medicare, which provides a partial rebate for up to 5 Speech Pathology sessions per calendar year for individuals with chronic conditions and complex needs that require a multi-disciplinary approach (treatment from several health professionals). Eligible conditions are those that are likely to be present for 6 months or longer such as Autism, Dyspraxia, Learning Disorders, Down Syndrome, ADHD, Cerebral Palsy, Cleft Lip and Palate, Chronic Middle Ear Infections, Intellectual Disability and severe speech or language impairments. For adults these may also include Stroke, Traumatic Brain Injury, Progressive Neurological Diseases (Motor Neurone Disease, Parkinson’s Disease), stuttering, vocal cord pathologies and Dementia.

Clients must obtain a Chronic Disease Management (CDM) referral from their GP who will lodge and complete a GP Management Plan and Team Care Arrangements Plan. Referrals are valid for 12 months and must be in place prior to the commencement of therapy in order to claim. Unused services from the same referral can be used in the following calendar year.

Please bring the CDM referral to your appointment. A receipt will be issued following full payment of your session at point of service that can then be taken to a Medicare office or uploaded onto the Medicare app.  The rebate is $52.95 per session, so out of pocket expenses are usually incurred. Please note, clients cannot claim a Medicare rebate and private health care rebate for the same service.

People of Aboriginal or Torres Strait Islander descent are eligible for another 5 sessions per calendar year in addition to the 5 annual CDM services. Eligibility criteria is identical to the 5 CDM sessions. The rebate for these additional services is also $52.95 per session.

For more information please contact your GP or click here

Further information for GPs is available here: Speech Pathology and the CDM program – Info sheet for GPs