Can you receive funding for your incontinence?
Much has been written about the social and psychological costs associated with incontinence, but less documented is its financial cost.
At the very minimum, being incontinent means having to spend money on aids such as continence pads or pants. But sometimes it can also mean having to pay for catheters and urine-drainage bags.
If you’re faced with the financial burden of incontinence, there are some ways you can receive funding, both public and private.
Commonwealth government schemes
The Continence Aids Payment Scheme (CAPS) is open to Australian permanent residents and citizens suffering from severe and permanent incontinence – so long as your incontinence was caused by an eligible neurological or other condition listed on the Department of Health bladder and bowel website. This includes incontinence caused by some cancers, as well as the radiotherapy used to treat them.
You must also be entitled to a Centrelink Pensioner concession card or a Department of Veterans’ Affairs concession card, or be the dependent of a cardholder.
Currently, it provides payment of up to $623.80, indexed annually and paid directly into your bank account around July each year.
You can read more about the CAPS payment scheme on the Department of Human Services website or call 132 011 and select option 6.
National Disability Insurance Scheme (NDIS)
If you live in an NDIS trial area, any entitlement to a payment will fall under the NDIS and not CAPS. To be eligible, you’ll need to be assessed by the National Disability Insurance Agency (NDIA).
As the NDIS is being rolled out across the country from July 2016, this will eventually replace the CAPS scheme altogether.
For more information, go to ndis.gov.au or call 1800 800 110.
Department of Veteran Affairs Rehabilitation Appliances Program
This program covers the cost of some continence aids and appliances for war veterans, their widows and dependents via the Rehabilitation Appliances Program (RAP). To be eligible, a medical health professional must have signed a form stating that you require the specific aid you’re claiming for. You’ll also need to hold a DVA gold card or white card and you can’t be receiving a Level 3 or 4 aged care package.
For more information go to defencecare.org.au or call 13 32 54.
State government funding
Every state also administers its own program for funding some of the costs of incontinence. Some let you make a claim in addition to your Commonwealth entitlements, while others don’t.
New South Wales
The NSW government’s EnableNSW scheme is open to people with permanent incontinence who aren’t entitled under any other scheme, including workers’ compensation. You must also have a Health Care card, Health Care Interim Voucher or Pensioner Concession Card. Under EnableNSW, funding is decided by product category rather than through a lump-sum payment and you’ll need to make a co-payment.
You can find out more at enable.health.nsw.gov.au or by calling 1800 362 253.
In Victoria, State-wide Equipment Program (SWEP) funds some continence aids but not the cost of disposable pads or pants. Again, to be eligible you need to suffer from permanent incontinence, be ineligible for any other funding (including via a private health fund) and hold a Medicare card. You’ll also need to have your condition confirmed annually by a qualified nurse and receive an updated script.
Find out more at swep.bhs.org.au or call 1300 747 937.
The Medical Aids Subsidy Scheme (MASS) provides funding for – or even provides – continence aids for use in the home. To be eligible, you can’t be receiving any other government funding under WorkCover or the DVA Rehabilitation Appliances Program or be entitled to workers’ compensation payments. But you can receive funding under CAPS. You’ll also need to hold a Pensioner Concession Card (issued either by Centrelink or DVA), Health Care Card, Health Care Interim Voucher or Queensland Seniors Card.
To find out more visit health.qld.gov.au/mass or call 1300 443 570.
The Continence Management and Support Scheme (CMASS) provides funding to people who’ve been suffering from a chronic or intractable incontinence condition for more than six months. To be eligible, you need to be assessed by a registered nurse from the Silver Chain Nursing Association. Your entitlement under CMASS may not be affected by any CAPS payment.
To find out more visit independenceaustralia.com or call Silver Chain on 1300 787 055.
If you’re registered with Disability SA or Disability Services, you may be entitled to some funding to cover the cost of continence products through the Department for Communities and Social Inclusion (DCSI). However, you must have a Department for Communities and Social Inclusion (DCSI) card and have already spent any CAPS allowance you're entitled to.
To find out more visit dcsi.sa.gov.au or call 1300 786 117.
The Department of Health and Human Services administers a Community Equipment Scheme (CES), which provides some of the cost towards continence aids. But you’ll need to make a co-payment). To be eligible under the scheme, you’ll first need to be assessed by an incontinence nurse. The scheme is open to people suffering from long-term incontinence, so long as they hold a Health Care Card, Pensioner Concession Card, Health Benefit Card or Interim Concession Card Entitlement.
To find out more visit dhhs.tas.gov.au.
Australian Capital Territory
ACT residents suffering from a permanent, long-term incontinence may be entitled to help with the cost of equipment that allows them to live at home. You can’t be receiving funding under any other scheme and you need to hold a Centrelink Pension or Health Care Card.
To find out more visit assistance.act.gov.au.
The Disability Equipment Program (DEP) is administered by the Northern Territory’s Department of Health and supplies equipment to people suffering from permanent and long-term incontinence.
To find out more visit health.nt.gov.au.
On top of this, if you have private health cover you may be entitled to claim some medical or other expenses related to your incontinence.
For instance, most health funds allow members to claim some of the costs associated with physiotherapy or other medical techniques associated with relieving your symptoms. But you’ll usually need a referral from your GP first.
Bupa’s Living Well program may allow you to claim Pilates classes and other exercise-based methods for controlling your pelvic floor or muscle strengthening. For HCF members, Pilates may also be claimable as a Health Management Program for clients with eligible HCF extras cover.
To find out more call:
Bupa: 1800 812 535
HCF: 13 13 34
Medibank Private: 13 23 31
NIB: 13 16 42
There may be other ways to fund some of the costs associated with your incontinence. You can find out more on the Continence Australia website or bladderbowel.gov.au or speak to your GP.