Unloader braces may be a cost-effective, non-invasive solution for sufferers of osteoarthritis. Various funding options may be available to you to help you finance your Unloader brace.
Private Funding Options
Private Health Insurance
Rebates vary according to different health funds and you usually need extra covers (similar category to optometry).
A medical referral is usually required and rebates may vary from $50 to 75% of the cost of the brace. Please confirm with your health fund prior to purchasing.
Items used to maintain a working lifestyle may be claimed on an individual’s tax return. Advice from a taxation advisor is recommended prior to claiming1. A deduction via net medical expenses rebate may also be possible2.
Public Funding Options
Third Party Insurers
Third party insurers e.g. Workcare or TAC can cover the full cost of the brace. A medical referral and quotation/approval (completed by the fitting centre) prior to fitting is usually required.
ACC - New Zealand
ACC's no-fault scheme covers everyone in New Zealand if you’re injured in an accident.
The scheme covers children, beneficiaries, students, if you’re working, unemployed or retired. If you’re injured, make sure you go and see your doctor or health provider first. They can apply to ACC to cover for your injury.
The cover ACC provides helps pay for costs to get you back on your feet. It includes payment towards medical bills, treatment, help at home and work, as well as income assistance.
Department of Veterans Affairs (DVA)
Eligible DVA cardholders can receive full funding for the brace. Completion of a RAP form and quotation/approval (completed by the fitting centre) prior to fitting is usually required.
State Equipment Funding
SWEP - State Wide Equipment Program (VIC)
Orthoses = $1200 per item, per year. A registered Orthotic provider must submit a request for funding, and the brace will usually need to be custom made/fitted3.
To be eligible for the program the client must:
- Have a permanent or long term disability/or are frail aged and are living independently in the community
- Require aids & equipment or home modifications from the aids availability list on a permanent or long-term basis and are a permanent Victorian resident
The client may not be eligible if:
- They live in a commonwealth funded residential aged care facility
- They receive aids and equipment through other government funded programs, such as WorkCover, Transport Accident Commission (TAC) or the Department of Veteran Affairs (DVA)
- They are able to claim the cost through a private health insurance provider
- They are an inpatient of a public or private hospital or
- They have been discharged from a public hospital within the past 30 days
EnableNSW - Aids and Equipment Program (NSW)
EnableNSW provides the most cost-effective, clinically appropriate devices that meet a person’s assessed functional need and that are consistent with the EnableNSW Prescription and Provision Guidelines for those devices. Devices provided must primarily promote long term functioning in the community, rather than provide treatment for acute and chronic care episodes4.
Access to EnableNSW is based on assessed functional or clinical need by an eligible prescriber which involves the submission of an EnableNSW Application Form and an Equipment Request Form.
Both forms must be submitted to determine eligibility and funding approval. Relevant forms are available on the Enable website5.
Funding levels are indexed to income with higher income earners still eligible but having to make a greater contribution.
MASS - Medical Aids Subsidy Scheme (QLD)
Eligible adult applicants (16 years and older) will be required to fund a contribution of $150 towards the cost of the prescribed orthosis. MASS will fund the remaining cost up to a maximum MASS funding of $1,995. The minimum reapplication period for further MASS subsidy for adults is eighteen months. Knee braces are included on the approved categories list.
Prescribers of orthoses through MASS must also be medical specialists seeing the applicants in a private capacity. Public health system prescribers will need to apply for orthoses funding through their local Queensland Health Service District. MASS will only accept quotations from orthotists who have a recognised degree in prosthetics and orthotics or who can demonstrate eligibility for membership to the Australian Orthotic Prosthetic Association (AOPA)6.
Funding is restricted to low income patients. For criteria MASS website.
CAEP - Community Aids and Equipment Program (WA)
Getting the equipment you need via CAEP7
- Ask your GP or specialist if you are eligible and to then refer you to a local CAEP service provider. This may be a public hospital, health or disability service.
- The CAEP service provider will arrange for a health professional such as a physiotherapist or occupational therapist to work out your equipment and/or home modification needs.
- Your health professional will order the equipment or arrange for the home modification. When the equipment arrives they will ensure it fits and provide training, maintenance and follow up as required.
Low-income government cardholders see the CAEP Referrers kit.
ACTES - ACT Equipment Scheme (ACT)
The ACT Equipment Scheme provides access to a range of equipment for eligible Canberrans. This is available for permanent residents of the ACT with long term illness or disabilities to assist them to live safely at home in the community9.
To be eligible for this service, you must be a permanent resident of the ACT who has resided in the ACT for at least six months and:
- Be ineligible to receive assistance from other government-funded schemes, private health schemes or through EACH package,
- Hold a current Centrelink Pension or Health Care Card,
- Or meet low-income criteria as outlined within the policy
TIMES - Territory Independence and Mobility Equipment Scheme (NT)
Covers daily living aids and equipment for government cardholders10.
To be eligible for the TIME Scheme, applicants must meet all of the following criteria:
- Have a disability of a permanent or long term duration as defined under the Disability Services Act (1993);
- Are a resident of the Northern Territory;
- Are living in or are returning to the community;
- Require items of approved TIME Scheme equipment on a permanent or long term basis;
- Are not eligible to receive compensation in respect of the disability for which the equipment has been prescribed; and
- Are not eligible to receive the equipment under any other Program/Fund;
- Are a beneficiary of a Centrelink Aged Pension, Centrelink Disability Support Pension, or person under 16 years for whom a family member is in receipt of a Centrelink Carer Allowance or Centrelink Carer Payment; or are a child in the care of the Minister; or have been approved as eligible on the basis of Financial Hardship; and
- Are not High Care residents of a Residential Aged Care Facility
For more information contact Orthotic Prosthetic Services Tasmania (OPST) on [email protected] or (03) 6222 7377.
- Tools, equipment and other assets – Australian Taxation Office (2015, August 18).
Retrieved from https://www.ato.gov.au/individuals/income-and-deductions/deductions-you-can-claim/tools,-equipment-and-other-assets/
- Medical assets, Australian Taxation Office (2015, September 22). Retrieved from https://www.ato.gov.au/individuals/income-and-deductions/offsets-and-rebates/medical-expenses/
- Applying for Aids and Equipment, State-wide Equipment Program (SWEP).
Retrieved from https://swep.bhs.org.au/applying-for-aids-and-equipment.php
- Assistive Technology for Communication, Mobility, Respiratory Function & Self-Care, EnableNSW (2011, May 12).
Retrieved from https://www.health.nsw.gov.au/policies/pd/2011/pdf/ PD2011_027.pdf
- EnableNSW – www.enable.health.nsw.gov.au
- Subsidies for aids and equipment at home, Queensland Government (2016, March 24).
Retrieved from https://www.qld.gov.au/health/support/equipment/subsidies/index.html
- Community Aids and Equipment Program (CAEP), Government of Western Australia.
Retrieved from https://www.disability.wa.gov.au/services-support-and-eligiblity/services-supports-and-eligibility-new/services/services-provided-by-the-commission/equipment-and-technology/community-aids-and-equipment-program-caep-/
- Community Aids and Equipment Program – Referrer’s Information Kit, Government of Western Australia (2014).
Retrieved from https://www.disability.wa.gov.au/services-support-and- eligiblity/services-supports-and-eligibility-new/services/services-provided-by-the-commission/equipment-and-technology/community-aids-and-equipment-program-caep-/
- Oxygen and Equipment Services, ACT Health.
Retrieved from https://www.health.act.gov.au/our-services/rehabilitation-aged-and-community-care/oxygen-and-equipment-services
- Disability Equipment Program, Northern Territory Government.
Retrieved from https://health.nt.gov.au/Aged_and_Disability/Office_of_Disability/Services_for_People_with_Disability/ Disability_Equipment_Program_DEP/index.aspx