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Children and young people with complex developmental or neurological conditions, such as autism, cerebral palsy, or Fragile X syndrome, can get help from Medicare to pay for some allied health assessments and therapy sessions.
Who is it for?
Your child may be eligible if:
- They are under 25 years old.
- They have a condition that affects two or more areas of their development, such as cognitive, language, or movement.
Eligible conditions include autism, hearing or vision loss, cerebral palsy, and some chromosomal conditions like Fragile X syndrome.
What help can you get?
If your child is eligible, you can claim Medicare rebates for allied health services such as speech therapy, occupational therapy, or psychology. You can claim:
- Up to 20 therapy sessions over your child’s lifetime.
- Up to 8 assessment sessions before your child turns 25.
- A maximum of 4 sessions per day.
What do you need?
You’ll need a referral letter from a specialist doctor, such as a paediatrician or psychiatrist. The letter must include the number of sessions your child needs.
Each therapist (for example, speech therapist or occupational therapist) needs their own referral letter. You’ll also need a separate referral for assessment sessions.
Referrals for therapy can include up to 10 sessions each time your child starts a new treatment plan.
How to apply
Ask your paediatrician or psychiatrist if your child is eligible for Medicare support. If you are, the doctor will give you a referral letter for each therapist your child needs to see.
You can then take this referral to your chosen allied health provider. Most providers can claim the Medicare rebate for you when you pay for the session, or you can claim it later through Medicare.
Need help?
Ask your paediatrician, psychiatrist, or diagnosing specialist for more information, or contact Services Australia.