Funding spreadsheet

I recently spent a while planning the various funding options I can use to pay for my children’s therapy this year, and decided to share a generic version of the spreadsheet I created.  Please note that this specifically references Australian Medicare plans, but could easily be adapted for similar programs in other countries.

Funding options (Excel spreadsheet)

To start with, you’ll need a calendar to type in every therapy appointment you have planned for this year.  I’ve put a line between each term, as I kinda like having a break during school holidays :).  Enter the therapists’ costs as well.

If you have private health insurance, check your level of cover to find out what rebate you receive for each therapy type, what the annual limits are, and when they reset.  The final four columns are for the amount remaining in each of the listed funding options.  If you had $200 remaining for Psych on 1st March, and your annual limits reset to $500 on 1st July – enter them both into the spreadsheet.  You will need to modify the formulae in those cells to be something like =500-G30 (assuming the first appt after 1st July is on row 30, the formula is the annual limit less the amount you’re claiming for this session, which would be in column G- the PH Psych column; the equals sign at the beginning tells Excel that it’s a formula to be calculated, not just text).

If you still have Fahcsia funding remaining (the $12,000 before age 7), enter the amount remaining in column N, in the row of the last date shown on your statement.

That’s all the initial setup.

Next is to consider which funding options to use when.  Quick overview:

  • HCWA is the 20 paediatrician-referred sessions with allied health professionals, to be used before the child reaches 15 years of age.  Generally it’s better to delay using these until the Fahcsia funding is completed, however children can’t receive funding from both Fahcsia/HCWA and NDIS- so you might want to plan to use your HCWA sessions before registering your child for NDIS.
  • An EPC (Enhanced Primary Care plan, now known as a Chronic Disease Management plan) can be written up by a GP for five Medicare-rebated allied health sessions per calendar year.
  • A Mental Health Care Plan (MHP) is a GP-referral to a psychologist or an OT with mental health training, for ten sessions per calendar year.  Autism isn’t sufficient for this referral, but several conditions often associated with it (eg anxiety, depression, OCD etc) are.

I have generally found that I receive a rebate from Medicare in the region of $75 per session for any of the above three plans.

Now that you have numbers and dates – start trialling different options to see what gives you the least Out of Pocket (OOP) expenses.  Private Health and Fachsia can be used pay for the same appointment; none of the others can be used together.

Then do it all again on the following sheet for your next child :).

One final word- I designed the spreadsheet to be as generic as possible, so if something isn’t relevant to you, please hide it rather than delete it, as deleting will mess up the formulae.  To hide a row/column, select the letter/number, right-click and select “hide” from the context menu.

Hope it’s helpful – happy to answer any questions.

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