If you are a parent or adult seeking speech therapy services in Australia, you might be curious to know if these specialist services are covered by Medicare. Medicare is Australia’s national insurance scheme that helps to subsidise and sometimes cover the entire cost of services for Australians.
Keep on reading to find out more about subsidised speech therapy services through Medicare and what this support is limited to.
Can Speech Therapy Be Claimed on Medicare?
The short answer – yes, speech therapy can be claimed on Medicare. However it is important to note that you will need to meet a few conditions to be eligible for this Medicare support and it will only be available for you to use for 5 speech therapy sessions each calendar year.
Medicare also currently (January 2024) only provides a small rebate on services – giving you approximately $58 back after each session.
Here’s what Services Australia have to say about eligibility:
Medical practitioners can refer eligible patients with chronic diseases to allied health practitioners. Allied health practitioners can claim Medicare benefits for some services.
To claim Medicare benefits for these services:
- an eligible allied health practitioner must deliver the service
- the allied health practitioner must bill the services using the correct MBS item number
- the patient must be eligible
- a medical practitioner must refer the patient
- the allied health practitioner must give reports to the referring medical practitioner.
As a team of passionate speech therapists, we’d like to draw your attention back to the 5 speech therapy sessions per calendar year. While this Medicare support can be a helping hand for families and individuals, in most cases you will need regular ongoing speech therapy to achieve your desired outcomes.
With each individual having such different goals, values, and reasons for seeking speech therapy, we can’t give an exact estimate on how long you’ll need to access speech therapy for, but you should note that the Medicare sessions will likely only help you to subsidise the start of your therapy journey.
Is Speech Therapy Covered By Insurance?
If you aren’t eligible for the NDIS (National Disability Insurance Scheme) you will need to privately fund your speech therapy services. We understand that this can be a big cost to individuals and families, so we’d like to share that there are some private insurance providers that offer extras cover that includes speech therapy services.
It’s important to read the documentation, research your options, and be mindful of waiting periods before selecting a health insurance provider for your speech therapy services. We do not recommend or endorse any particular insurance provider but do hope that you are able to find an option to support you if privately paying for services is your best option for accessing services.
We hope you’ve found this article helpful in your search for more information on accessing speech therapy in Australia. If you’d like to join our waitlist for accessing speech therapy in Townsville or Mackay, register for our services here.