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Other funding options to support autistic adults
As well as the NDIS, there are other state and federal funding options to support autistic people.
Understanding what these options cover and whether you or your autistic loved one is eligible can help you access important services to improve your health, wellbeing and quality of life.
NDIS funding and supports for participants are constantly changing. What might have been funded previously may have changed under the new NDIS legislation. It's important to ensure that you are up to date with the current information and updates.
Information on this page is current as of November 2024.
Mental health care - Medicare
When experiencing emotional and mental health concerns that do not require emergency help, seeing your doctor is the best way to assess what level of supports and services you may need.
When you see your doctor, they’ll assess what help you need. This could include:
- Making a mental health assessment.
- Creating a mental health treatment plan.
- Referring you to a psychiatrist, psychologist or other mental health professional.
- Giving you a prescription for medicines.
Your doctor might ask you some personal questions to understand your situation. Sometimes it can be hard to talk to others about your mental health. You can read tips for talking to your doctor about mental health on the Healthdirect website.
If your doctor bulk bills, Medicare covers the cost of the appointment. If your doctor doesn’t bulk bill, you’ll need to pay either:
- The full cost.
- The difference between what they charge and what Medicare covers.
If you pay the full cost, you can make a claim for the amount Medicare covers. Your doctor can also make a direct claim on your behalf.
Medicare rebates for diagnosis of autism (Complex neurodevelopmental disorder and eligible disability)
Medicare MBS items are available for diagnosing and treating patients with eligible disabilities. Patients with both an eligible disability and complex neurodevelopmental disorder (such as autism spectrum disorder) can access MBS services associated with these programs. When creating a treatment and management plan, you should consider both conditions.
The patient must be under 25 years of age to have:
- Allied health MBS items for assistance in diagnosing the patient or contributing to a treatment plan.
- A treatment and management plan prepared by a specialist, consultant physician or general practitioner.
The patient must be under 25 years of age to have allied health MBS items for treatment services. See more at Services Australia.
Mental health treatment plan
A mental health treatment plan lets you claim up to 10 sessions with a mental health professional each calendar year.
First, your doctor or psychiatrist will refer you for up to 6 sessions at a time. If you need more, they can refer you for further sessions. Health professionals set their fees, so Medicare may only cover some. Ask how much you’ll pay and what you’ll get back from Medicare when you make your appointment. If they bulk bill, you won’t have to pay anything. If you have private health insurance, you may be able to get some money back. You can check with your insurer.
Rural and remote services
If you live in a rural or regional area, seeing a mental health professional might be hard. You may be able to have a telehealth video consultation instead. You can claim for video consultation sessions with a mental health professional. Ask your GP or mental health professional if they offer this service. Visit this page on bulk billing and this page on mental health care and Medicare for more information.
Private health cover
Private health insurance can assist with some of the costs of health services you access. Each private health fund charges differently and is also dependent on what level of services you want. For example, there can be bronze, silver, and gold levels of insurance, and these can be just for extras and/or hospital cover. Each level will cover a certain amount of the fee and/or will have an overall limit on how much funding you can use over one year.
It is worthwhile considering how often you will use services that directly support your needs, and the costs compared to how much you will pay in private health insurance. If you use services infrequently, paying for the service may be cheaper in the long term each time you use it.
Disability Support Pension (DSP)
The Disability Support Pension (DSP) provides financial support when you are unable to work due to a permanent physical, intellectual, or psychiatric condition. You must access this through Centrelink. You will need to meet both medical and non-medical rules in order to be eligible.
Non-medical rules
- Be aged between 16 and the age pension age
- Meet the Australian residency rules and
- Meet the income and assets test
Medical rules are
- Your condition will last more than 2 years
- Your condition is fully diagnosed, treated and stabilised
- You have an impairment rating of 20 points or more
- You meet Program of Support rules, if these apply to you
- Your condition will stop you working at least 15 hours a week in the next 2 years.
If you meet all of these rules, you may be able to get DSP. For more information on accessing the Disability Support Pension, you can visit the Services Australia website.