Access to allied health services

Allied health professionals provide a range of critical health and health-related services for Australian consumers across a broad range of conditions. The breadth of services provided by allied health practitioners means that there are a range of situations in which you might access those services.

If the need for allied health services arises from treatment received in hospital, most or all of those allied health services are likely to be provided by allied health professionals employed by that hospital. However many allied health services are provided in the community, often by practitioners operating in private practices. Access to these services may be supported through government programs or other sources of funding. The list below covers many of the key options available to consumers.

Do I need a referral to access services?

Allied health services can usually be accessed directly by any patient paying privately without a referral. This includes people who may claim rebates through a private health insurer. However, a range of national and state-based funding schemes and programs are available to help people access allied health services by meeting some or all of the cost of allied health services. That includes services provided by community or aboriginal health services, Medicare funded services, and allied health services provided by aged care or disability providers. In these cases you may need a referral, typically from a general practitioner.

Which programs provide access to allied health services?

The following services and programs can help people meet the cost of accessing allied health services.

Department of Veterans Affairs (DVA)

The DVA funds a wide range of allied health services required by veterans and/or their widows if they are holders of a DVA Gold Card. Similar funding is available for DVA White Card holders where those services are required because of their accepted war-caused or service-related condition(s).

Allied health providers do not require a contract or agreement with DVA though they do require a DHS provider number. DVA funding of allied health services is bound by the conditions of the DVA fee schedule. More information for allied health practitioners and for veterans and their families is available via the link below.

More information: https://www.dva.gov.au/providers/allied-health-professionals

Medicare

Medicare includes a range of programs to provide access to allied health services. These cover a broad range of allied health professions and a range of services though some allied health professions do not currently attract Medicare rebates. In addition to specialised funding for optometric, audiological and diagnostic services, Medicare also has programs to provide access to services for people with chronic illnesses, children with autism,  and those experiencing mental ill health. Access to Medicare funding for most services, apart from optometry and audiology, requires a referral from a general practitioner. Typically a general practitioner will work with you to first diagnose a health issue and then to discuss appropriate options.

Private Health Insurance

Private health insurance is becoming an increasingly important source of funding for health services including allied health services. General treatment insurance, more typically referred to as Extras cover, can help fund the cost of allied health treatments. However, it is important to note that there is significant variation in what individual policies cover and it can be difficult to calculate what rebate you will receive when accessing an allied health service. In some cases, the costs of general treatment insurance may be higher than the benefits you are likely to receive. AHPA is very supportive of private health insurance rebates for allied health services but recommends people carefully consider the services they may need and spend time researching which policies best meet those needs.

More information: https://www.choice.com.au/money/insurance/health/articles/do-you-need-private-health-insurance

My Aged Care

Older people that are deemed eligible are now able to access funded services, including allied health services, through the My Aged Care portal. The older person can be referred by a family member or health professional and will then be assessed by either a Regional Assessment Service (RAS) or an Aged Care Assessment Team (ACAT) to determine their level of need. They may then be assigned funding through either Commonwealth Home Support Programme if they require only minimal support, or through a Home Care Package if they have more complex needs. Once an older person is assigned funding, they are able to access a range of allied health services including physiotherapy, podiatry, speech pathology, occupational therapy and dietetics.

Community health services

State and Territory governments in Australia fund access to a range of health services, including allied health services, through local community health services. These services are intended to provide universal access to a range of health providers with a particular focus on delivering targeted services for vulnerable population groups. Community services provide a wide range of different allied health services including audiology, dietetics, physiotherapy, occupational therapy, podiatry, and speech pathology. These will vary from service to service. While any person is eligible to see a health provider in a community health service, people experiencing disadvantage and poor health due to their economic and social situation are prioritised.

More information: As the services offered will vary between and within States and Territories, AHPA recommends searching online or contacting your local council for more information.

Primary Health Network programs

Primary Health Networks (PHNs) have been established with the intention of coordinating and tailoring primary care services according to the health needs of the population they oversee. PHNs focus on working with practitioners across the primary health care sector to help tailor and support services that meet the health needs of the local community. In addition PHNs have a particular focus on supporting access to mental health services. PHN-funded mental health programs include the Access to Allied Psychological Services (ATAPS) program which funds services for people who may otherwise struggle to access the support they need due to their financial situation.

More information: The services offered by individual PHNs will vary. The PHN directory can help you determine which PHN provides services in your area and you can then visit their website or contact them for further information.

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