Australian Incontinence Product Funding Schemes

Managing incontinence for the person you care for can be a financial burden, so make sure you’re aware of what assistance you may be entitled to.

There’s no doubt navigating the available schemes to assist with the payment of incontinence products is complicated, but an overall understanding of what’s available should help point you in the right direction.

Where you live and the condition of the person you care for will affect eligibility, but here’s an overview for Australian residence.

Australian Government

Continence Aids Payment Scheme or CAPS

  • Current (financial year 2017-2018) payment is $583.20 and is indexed annually
  • For people over five years of age with permanent and severe incontinence caused by an eligible neurological condition  OR other eligible condition AND is a holder of Centrelink or Department of Veteran’s Affairs Pensioner Concession Card
  • For those NOTreceiving continence aid funding through the NDIS, a Home Care Package (MyAgedCare) or Rehabilitation Appliances Program (RAP through DVA)
  • Apply through the CAPS website, or Medicare or call the Medicare Helpline 132 011

 

National Disability Insurance Scheme or NDIS

  • You must be under 65 years of age and have a disability that requires assistance (technical, personal, modification of home, etc.) to be eligible for an NDIS package
  • If continence issues are as a result of your disability, you should be eligible to include the cost of products and aids in your plan
  • The payment amount will depend on individual requirements detailed and approved in your plan
  • Email questions to enquiries@ndis.gov.au or call 1800 800 110

 

Department of Veteran Affairs or DVA

  • Funding is available under the DVA’s Rehabilitation Appliances Program or RAP
  • All cases are individually assessed for eligibility, but for White Card holders, their incontinence must be related to a war injury, whilst Gold Card holders’ eligibility is broader
  • All applicants must be clinically assessed and, if eligible, funding will cover the costs of prescribed incontinence products in quantities recommended by a healthcare professional
  • You can find out more about RAP’s Continence program, including contact details on this link  

MyAgedCare

  • MyAgedCare is the Australian Government program that funds aged care services for people aged 65+(50+ for Aboriginal and Torres Strait Islander people) finding it harder to do the things you used to do
  • An individual is eligible if they are admitted to a public, private or NFP aged care facility
  • If an individual is on a Level 1 or 2 Home Care Package they can receive funding for continence aids if they meet the criteria and if they’re on a Home Care Package Level 3 or 4 (formerly known as Extended Aged Care at Home (EACH) package or an Extended Aged Care at Home Dementia (EACH D), care plans can also include continence aid

State Government

With the exception of South Australia, all states and territories have their own schemes that will fund incontinence aids for eligible participants. Note that the Victorian scheme, SWEP, does not fund disposable pads or pants.

The rules for each program are different and the information provided is a simplified overview. Contacting the program’s administrators for further information is recommended.

 

NSW – Enable

  • This program is specifically for people with a disability who have moderate to severe incontinence
  • They may also be receiving CAPS but find it insufficient to meet their needs
  • Funding is determined by the number of products required a year and is influenced by the incontinence being urinary, faecal or both
  • For more information on eligibility and how to apply, call 1800 362 253

Victoria - State Wide Equipment Program or SWEP

  • Up to $1200 per year, but does NOT fund disposable pads and pants but does fund washable continence pants, catheters, drainage bags, urine bottles, washable bed & furniture covers, floor & chair mats
  • If you have been unsuccessful in receiving a package through the NDIS, you may still qualify for SWEP
  • If you’re receiving funding for disposable products through CAPS, you may still be eligible to have non-disposable items funded through SWEP
  • Head to the website or contact SWEP directly on 03 5333 8100 or 1300 747 937 or email swepcont@bhs.org.au to find further details on eligibility and how to apply

 

South Australia

  • There is no specific state-based scheme in SA, but residents are eligible for funding support through the national programs – CAPS, NDIS or DVA

Queensland – Medical Aids Subsidy Scheme or MASS

  • Funding varies according to assessment and they will fund both disposable and non-disposable continence aids
  • To be eligible, participants must
    • Be a permanent Queensland resident aged over five years, with a disability
    • Hold a Pensioner Concession Card (issued either by Centrelink or DVA), Health Care Card, Health Care Interim Voucher, or Queensland Seniors Card
    • NOT be in receipt of assistance from other government programs such as WorkCover or DVA Rehabilitation Appliances Program or compensation or damages in respect of their disability
  • Clients may receive MASS assistance in addition to CAPS
  • For more information on eligibility and how to apply, phone (07) 3136 3665 or 1300 443 570 (toll-free) or email MASS-ContinenceAids@health.qld.gov.au

 
Western Australia – Continence Management and Support Service or CMASS Outsourced by the Western Australian Government to Silver Chain

  • To be eligible, participants must
    • Be 16 years of age or older and a permanent resident of Western Australia
    • Have a defined chronic or intractable continence condition (lasting six months or more) 
    • Hold a Pensioner Concession Card or a Health Care Card
    • Not be in receipt of a Commonwealth Home Care Packages (Level 1 to 4) or living in a Commonwealth funded high-level residential care home. 
  • For more information on eligibility and how to apply, call 1300 787 055 or email info@silverchain.org.au

 

ACT – ACT Equipment Scheme or ACTES

  • This scheme funds up to 270 disposable pads/pants each quarter
  • To access the scheme, participants need a referral from their health professional
  • To be eligible, you must
    • Have been a resident in the ACT for at least six months
    • Be ineligible to receive assistance from other government-funded schemes including the NDIA, private health funds or through a Home Care Package
    • Hold a current ACT Centrelink Health Care Card, excluding a Seniors Health Care Card (SHC) or Mobility Allowance Health Care Card (MO)
  • For further information, including eligibility and how to apply, call (02) 6207 0658 or email acthealthcontinence@act.gov.au

 

Tasmania – Community Equipment Scheme or CES

  • This scheme requires a 50% co-payment by the participant, to a cap of $1000 (of which the scheme will contribute $500)
  • Applicants must have a clinical assessment by a continence nurse advisor
  • To be eligible, participants must be
    • Aged six years or over, or if under six, be referred by a Paediatrician
    • Have a condition or disability resulting in incontinence
    • Have a long‐term disability or require equipment as part of discharge planning from hospitals or residential aged care
    • Hold a Health Care Card, Pensioner Concession Card, Health Benefit Card or Interim Concession Card Entitlement
    • Not received compensation or damages in respect of the disability for which the equipment is prescribed nor be receiving continence funding from CAPS or DVA continence assistance.
  • For further information, contact CES in your area directly 

    South                    6166 7393
    North                     6336 5036
    North-West           6426 2429

 

Northern Territory – Disability Equipment Program or DEP

  • Will fund equipment and aids (including disposable items) with the amount varying on a case by case basis
  • Eligibility includes:
    • Residents of all ages in the NT, living in or returning to the community
    • Having a permanent or long‐term disability and requiring equipment on a permanent or long‐term basis
    • Receiving a Centrelink Aged Pension, Centrelink Disability Support Pension, or person under 16 years for whom a family member is in receipt of a Centrelink Carer Allowance or Payment
    • Not being eligible to receive compensation for the disability for which the equipment has been prescribed and are not a Level 3 or 4 resident of an aged care facility

  • For further information, contact DEP in your area
    • Darwin                   (08) 8922 7244
    • Darwin remote      (08) 8922 8317
    • Katherine              (08) 8973 8778
    • Alice Springs         (08) 8951 6744
    • Nhulunbuy            (08) 8987 0400
    • East Arnhem         (08) 8987 0432

 

Other useful resources

The Continence Foundations of Australia has a great fact sheet that you can download that gives additional information on each state scheme, including eligibility, contact details and how to apply.



Source:

Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.