Navigating Medicare and NDIS Funding Systems

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By Psychologist, Judy McKay

Navigating the healthcare system can be complicated and confusing. To assist our families in accessing the services and benefits they need, an attempt to compile the key information relevant to seeing a psychologist has been gathered for you. 

Medicare Tip Sheet: 

Better Access to Psychiatrists, Psychologists, and General Practitioners through the MBS fact sheet for patients (health.gov.au)

Key Points

  1. Your child is eligible for up to 10 Medicare rebatable sessions (6 session pack + 4 session pack) per calendar year. Due to COVID-19, the number of eligible sessions has increased to a total of 20! NB: Access to the extra 10 sessions is set to expire on the 30th of June, 2022. 
  2. Medicare Rebate eligibility:  You must first book an appointment for your child with their GP (easiest option), Psychiatrist or Paediatrican. Ask for a Mental Health Treatment Plan (MHTP). The doctor will ask your child some questions about their mental health and ‘make a diagnosis’ (NB: A ‘diagnosis’ is required in order to receive a MHTP). Once you have the plan, send a copy to us (admin@centreforchilddevelopment.com) so we have it on file and can charge you accordingly!
  3. ‘Additional Courses of treatment’ (i.e., After 6 and 10 psychology sessions have been completed). In order to receive up to 20 psychology sessions under Medicare, your child will need to see their doctor after six, ten and twenty sessions for an update/review. If the doctor feels the child will benefit from further sessions, they will create an additional course of treatment. Send a copy of the additional course of treatment (i.e. 4 or 10 session pack) to us.  
  4. Alongside step 3, your psychologist will write a letter to your doctor after 1, 6, 10 and 20 sessions to update them on your child’s progress and any ongoing challenges. The psychologist will recommend an additional course of treatment if they feel it’s necessary. 
  5. If your child reaches the maximum number of MHTP sessions in a calendar year (currently 20), they can ask for a new MHTP from their doctor at the start of the next year and start over. They can of course continue seeing their Psychologist at the Northern Centre for Child Development even once they have used their 20 sessions in a year! However the sessions will not attract a medicare rebate. At this point, families with private health insurance sometimes use their ‘extras’ benefits, while other families pay privately. 

National Disability Insurance Scheme (NDIS)

A number of relevant fact sheets to help families navigate the NDIS and available funding categories can be found using the below link:

https://www.ndis.gov.au/about-us/publications/booklets-and-factsheets

For children under 7, information about the NDIS early intervention funding can be found here:

https://www.ndis.gov.au/understanding/families-and-carers/early-childhood-approach

The 3 Participant Booklets are particularly useful in providing a step-by step guide for applying and maintaining NDIS Funding. 

Step 1. Understanding the NDIS: https://www.ndis.gov.au/media/80/download 

Step 2. Planning: https://www.ndis.gov.au/media/333/download

Step 3. Using your NDIS Plan: https://www.ndis.gov.au/media/336/download

Key Points: 

  • NDIS funding eligibility criteria: Aged 7-65 years of age, live in Australia or have residency, require support due to a disability and the appropriate support will reduce the level of need required in the future. NB: Children under 7 years of age with a disability or diagnosed developmental delay can access NDIS funding through the Early Intervention funding category. To continue to receive this funding from age 7+, a diagnosis such as Intellectual Disability, Autism etc.,  is normally required. 
  • NDIS Plans accepted by the Northern Centre for Child Development are self-managed (i.e., the family manages the funds) or plan-managed (an NDIS plan manager will manage the funds and pay the support providers on your behalf). 
  • An NDIS Plan is typically developed by a local area plan manager in collaboration with the family. Once you have an NDIS Plan, email a copy to us and let us know if it is self- or plan-managed so we can charge you accordingly. 
  • Typically, after a year of receiving services and support, a review of the NDIS Plan and funding takes place. In preparation for this review, the family often requires a report from the child’s therapists outlining their progress and obstacles over the last year. You can ask your psychologist at CCD to write an NDIS Review Report (the best time to ask for this is 3 months prior to the review date). 

Hopefully this hasn’t made you feel more confused than you already were! If you have any questions about the Medicare or NDIS Plan  process, your psychologist or our wonderful admin team will be able to assist you further!

Judy is a registered psychologist with a Master’s degree in Educational and Developmental Psychology. Judy has experience working with young people, their families and extended support networks across educational, clinical and community-based settings. Judy enjoys working creatively and flexibly with children and adolescents to explore their difficult emotions and experiences. In the past, Judy has supported young people experiencing a range of neuro-developmental disorders, anxiety, trauma, social skill and emotional regulation difficulties. Judy values the individual needs of each client and attempts to incorporate their personal interests, strengths and goals throughout therapy. Judy utilises a client-centred approach to her therapy which is grounded in cognitive-behaviour therapy and other evidenced-based techniques.

Judy has a background in providing pastoral care to children and adolescents within educational settings. These experiences have enabled Judy to connect and build relationships with students of all ages, in addition to understanding the challenges typically faced by school-aged children. Judy encourages her clients to take a holistic approach to therapy and values communication with a client’s wider support network. This helps to promote positive client outcomes across all aspects of day to day life. Outside of work, Judy loves spending time at the beach or in the countryside. She further enjoys playing social sports and prioritises spending time with friends and family.

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