Referrals & Rebates

Because both Kate and Danielle are Speech Pathologists, clients may be eligible for a rebate via Medicare or through their private health insurance fund.

Medicare:

If your GP feels it is appropriate they may place a child or adult on an Enhanced Primary Care Plan. The guidelines generally state that there must be a chronic condition (i.e. more than 6 months in duration) that requires ongoing care from the GP and at least 2 other care providers (e.g. dentist, ENT, physiotherapist, speech pathologist, occupational therapist). Individuals with a tongue thrust would typically meet those criteria. The EPC Plan will enable a rebate to be obtained for a portion of the fees, for 5 appointments per year. We must have a copy of the plan in order for a rebate to be obtained.

Private Health Insurance:

A rebate may also be obtained if a child or adult is covered under a private health insurance policy that grants rebates for Speech Pathology services. The exact amount will depend upon the insurance provider and the level of cover. No referral is needed in order to obtain a private health insurance rebate, as long as the level of cover is appropriate.

NOTE: Clients are required to settle their accounts with Sydney SPOT first, and then invoices and receipts may be submitted to either Medicare or a private health insurance fund, to obtain the rebate.

Please do not hesitate to contact us should you have any questions regarding fees and rebates.