Eligibility and financial criteria
Eligibility criteria
The following criteria applies to all applications for EnableNSW assistive technology programs:
- they are a resident of NSW or Lord Howe Island, or are an asylum seeker, refugee or humanitarian visa holder residing in NSW or Lord Howe Island;
- they are enrolled with Medicare
- the assistive technology is prescribed to support a health need; and,
- they are not receiving or eligible for assistive technology through a third party insurance or other Commonwealth, state or territory government schemes for the identified health need. Possible alternative funding sources are:
- National Disability Insurance Scheme (NDIS)
- Department of Veterans’ Affairs
- Australian Government aged care services
- Compensation or damages for the condition requiring assistive technology (e.g. worker’s compensation)
- they are not an in-patient at a private hospital.
We understand every person’s situation is different. Please use the eligibility indicator to assess your eligibility for EnableNSW programs and services before you apply. You can also call our dedicated team of customer service officers on 1800 362 253 Monday- Friday 9am – 5pm to discuss your individual situation.
Financial criteria
People accessing EnableNSW are required to pay a co-payment each financial year they receive assistive technology, consumable re-orders or repairs and maintenance.
EnableNSW income bands for assistive technology, except prosthetic limbs, are based on the former Program for Appliances for Disabled People (PADP) income bands and allowances, with adjustments for increases in the Australian Consumer Price Index since December 1998. No changes have been made to the level of consumer co-payments.
EnableNSW income bands for prosthetic limbs remains the same as the previous criteria for the Prosthetic Limb Service.
Income bands and consumer co-payments
| Banding | Consumer co-payment |
|---|---|
|
Band 1 – Adults on full pension and children under 16 years | $100 each financial year accessing services |
|
Band 2 – taxable income up to $42,000 (single) or $70,000 (couple) + $2,100 per dependent | $100 each financial year accessing services |
|
Band 3 – taxable income above $42,000 (single) or $70,000 (couple) + $2,100 per dependent |
20% of equipment costing $800 and above Note: Consumers in Band 3 are not eligible for equipment under $800. |
| Banding | Consumer co-payment |
|---|---|
|
Band 1 – Persons holding a valid Pensioner Concession Card, a valid Health Care Card or a valid Commonwealth Seniors Health Card | Nil |
|
Band 2 – All persons not holding valid Pensioner Concession Card, a valid Health Care Card or a valid Commonwealth Seniors Health Card | 15% of the scheduled cost of the provision, maintenance and repair of prostheses up to a maximum of $200 per financial year. |
Validation of income band
People’s income band is to be verified by the production of:
- A statement of full pension entitlement from Centrelink; or
- Copy of a Centrelink Pensioner Concession Card; or
- A valid Australian Taxation Office (ATO) Notice of Assessment for the preceding financial year.
Discretion may be applied in instances where an ATO Notice of Assessment is not available, for example, for some 16 year olds who have yet to be assessed and for newly-arrived migrants or refugees. People who are over 16 years of age and are applying for assistive technology other than prosthetic limbs are required to submit a valid ATO Notice of Assessment to establish access to the appropriate income band, including:
- Applicants with taxable incomes who are part-pensioners;
- Commonwealth Seniors Health Care Card holders; and
- Self-funded retirees.
People who do not provide verification of income will be considered as Band 3.
Make an online co-payment
There are three (3) ways to make an online co-payment, including:
- a credit card payment using the safe and secure platform
- a BPAY payment using the information on the back of the approval letter
- a direct transfer to the HealthShare NSW account using the information on the back of the approval letter.
A co-payment is only required when you receive the equipment or when you access the service (including a repair or a consumable reorder), however it is capped at one $100 payment per financial year.
For example, if you were loaned a wheelchair on 1 July and required a repair 6 months later, you only need to make one co-payment that financial year.
A financial year is a 12-month period that runs from 1 July to 30 June in any year.
For all other payments, including invoices issued by Accounts Payable or an authorised supplier, please continue to follow the payment instructions on the invoices you receive.