Funding options for lymphoedema assessment and treatment

At Toowoomba Lymphoedema OT, we understand that the cost of ongoing lymphoedema care can be a concern. The good news is that several funding options may help cover or subsidise appointments, compression garments, and related therapy.

This guide outlines the main pathways available for people accessing lymphoedema services with an Occupational Therapist in private practice.

1. GP Management Plans (Medicare Rebates)

Lymphoedema and other oedemas are considered a chronic medical condition therefore your GP can create a Chronic Disease Management Plan (also known as a GP Management Plan).

This allows you to claim a Medicare rebate for up to five allied health sessions per calendar year which includes occupational therapy for lymphoedema.

You’ll pay for your appointment at Toowoomba Lymphoedema OT and then claim the rebate (currently $61.80 per session) back from Medicare.

Tip: Ask your GP for a Chronic Disease Management Plan and request that lymphoedema treatment be included.

2. Private Health Insurance

Most private health funds provide some cover for occupational therapy under extras policies. The rebate amount and number of sessions vary depending on your level of cover.

If your private health insurance includes OT services, you can usually claim on the spot after your appointment at Toowoomba Lymphoedema OT.

It’s best to check directly with your fund for:

• How much you’ll receive per session

• Any annual limits

• Whether compression garment fitting or reviews are included

3. My Aged Care (Home Care Packages)

If you receive support through My Aged Care, your lymphoedema management may be funded through your Home Care Package (HCP).

To access services this way:

1. Let your home care provider know you’d like to see Toowoomba Lymphoedema OT for lymphoedema treatment.

2. Your provider can arrange a contractor agreement with us.

3. Once the agreement is in place, your sessions and garment costs may be funded through your HCP budget.

For assistance in organising this, please contact us to talk through the steps.

4. Department of Veterans’ Affairs (DVA)

If you hold a DVA Gold Card (or a White Card for an accepted condition), you may be eligible for fully funded lymphoedema treatment when referred by your GP.

Toowoomba Lymphoedema OT is registered with DVA and can provide:

• Lymphoedema assessments and ongoing therapy

• Compression garment prescription and fitting

• Education and self-management strategies

Your GP can submit a D904 referral form for Occupational Therapy (Lymphoedema).

5. National Disability Insurance Scheme (NDIS)

If your lymphoedema is linked to your NDIS-recognised disability, you may be able to use your NDIS funding to access lymphoedema management.

If lymphoedema is unrelated to your disability, it generally isn’t covered — but your GP or support coordinator can help determine eligibility.

6. Queensland Health Compression Garment Subsidy

For eligible clients, the Queensland Health Compression Garment Subsidy Scheme provides financial assistance toward the cost of compression garments prescribed by an accredited lymphoedema practitioner.

We can help you determine eligibility and guide you through the application process.

Making Lymphoedema Care Accessible

Everyone’s funding situation is a little different, and sometimes multiple options can be combined, for example, using Medicare sessions first and private health or My Aged Care thereafter.

At Toowoomba Lymphoedema OT, we’re happy to help you navigate the options and find the best way to access the care you need.

Book an Appointment or Enquire About Funding

If you’re unsure which funding options apply to you, contact Toowoomba Lymphoedema OT for friendly advice and guidance.

We provide lymphoedema services for people across Toowoomba and Darling Downs region.