Financial

You may find living with inflammatory bowel disease financially challenging. Doctors’ appointments, medical tests and medication can be costly but there are Government and community initiatives you can access to help you save money living with inflammatory bowel disease (IBD) or caring for someone who has IBD. 

About IBD and disability

Is IBD a disability?

Crohn’s disease and ulcerative colitis are described as disabilities by the Disability Discrimination Act (DDA), which protects people from being discriminated against and treated less fairly than someone without a disability. This applies to employment, education, buying property, goods and services, renting, dealing with banks, insurance companies, accessing government services and several other areas. 

However, under the DDA there are some circumstances where discrimination is not unlawful. For example, occupational requirements, insurance and other situations including where an exemption has been granted.    

Further information and links to State & Territory Agencies that also deal with discrimination issues is available at Australian Human Rights Commission. 

Can the National Disability Insurance Scheme (NDIS) help me?

The NDIS provides funding to eligible people with a disability to help them gain more time with family and friends, greater independence, access to new skills, jobs, or volunteering in their community, and an improved quality of life. The NDIS also connects anyone with disability to services in their community.

To be eligible, your disability needs to be significantly impairing your intellectual, cognitive, neurological, sensory, physical, or psychosocial functionality in a way that specific assistance is needed to help you manage and take part in daily life activities. The NDIS takes into account impairment and permanence when deciding on eligibility. 

For people with IBD, access to the NDIS could be available to those who have other comorbidities or disabilities that meet the NDIS requirements. 

You can find out more about eligibility at Am I eligible for NDIS?, or specific conditions likely to meet disability requirements at Applying to the NDIS.

If you are not eligible for NDIS, there is a list of other support services available on NDIS support for people who are not eligible.

Can I access the Disability Support Pension (DSP)?

The DSP provides financial help if you have a physical, intellectual or psychiatric condition that is likely to persist for more than 2 years and stops you from working. Though IBD is described as a disability in the Disability Discrimination Act, this does not mean you are automatically entitled to the DSP. To get the DSP, you must meet both:

• non-medical rules, and 
• medical rules. 

Current medical evidence from your treating doctors about each condition and how it affects your ability to work are a key part. People with IBD whose treatment is effective and allows them to work, would not be able to claim the DSP. 

If you are unable to get the DSP, you may be able to receive other payments. 

How can Disability Employment Services (DES) help me?

DES help people with disability, injury or a health condition prepare for, find and keep a job. 

The DES has 2 services available:

• Disability Management Service: for job seekers with disability, injury or health condition who need assistance to find a job and occasional support in the workplace to keep a job.
• Employment Support Service: for job seekers with permanent disability who need help to find a job and who need regular, ongoing support in the workplace to keep a job.

For more information, please visit Disability Employment Services. 

The JobAccess website can provide you with information on employment with a disability. 

Medicare support services

Medicare is Australia’s universal health care insurance system. When you enrol in Medicare, the Government pays some or all of the costs of your necessary health care. The Medicare Benefits Schedule (MBS) is a list of health professional services that are made less expensive by the Government. It includes medical and allied health consultations, diagnostic tests, and operations. Some common Medicare subsidised services that people with Crohn’s disease and ulcerative colitis use include colonoscopy for managing IBD, blood tests for indicators of inflammation and vitamin levels, calprotectin testing (indicates inflammation) for diagnosing IBD, surgical procedures and GP, gastroenterologist or allied health consultations. 

There are MBS services to help people with chronic conditions such as Crohn’s disease or ulcerative colitis such as Chronic Disease Management Plans, and Mental Health Treatment Plans.

How can a Chronic Disease Management Plan help me?

You can speak to your GP about your health care needs and treatment options, and they can prepare for you a:

• General Practitioner Management Plan, and/or
• Team Care Arrangement. 

What is a General Practitioner Management Plan? 

A GP Management Plan (GPMP) can help people with chronic medical conditions by providing an organised approach to care. A GPMP is a plan of action you have agreed with your GP. This plan:

• identifies your health and care needs, 
• sets out the services to be provided by your GP, and
• lists the actions you can take to help manage your condition.

What is a Team Care Arrangement? 

As IBD may require many healthcare professionals to be involved in your care, your GP may also develop Team Care Arrangements (TCAs). These will help coordinate the care from your GP and other healthcare professionals (e.g., dietitian, physiotherapist, psychologist) and subsidise some of their consultation costs for up to six visits, in total, across all healthcare professionals each year.

Let your GP or nurse know if there are aspects of your care that you do not want discussed with other healthcare professionals.

What can I do to become eligible for Medicare rebates?

If you have both a GPMP and TCAs prepared for you by your GP, you may be eligible for Medicare rebates for specific individual allied health services that your GP has identified as part of your care, for example dietitian or physiotherapist. The need for these services must be directly related to your chronic condition. Any costs not covered by the Medicare rebate will need to be covered by you or your insurer if you have private health insurance.

CCA have developed individualised Crohn’s disease and ulcerative colitis Management Plan templates that you can use with your GP and other healthcare professionals to help with information for your management plan. Visit Crohn’s disease and ulcerative colitis Management Plans.

Visit Services Australia Chronic disease GP Management Plans and Team Care Arrangements for more information. 

How can a Mental Health Treatment Plan help me?

People with IBD are more likely to experience significant mental health problems, such as depression and anxiety. The gut and brain are closely connected, so it’s important to take care of both the mind and body to manage IBD well. For further information, visit Psychological Health & IBD.

A mental health treatment plan is available to you if you have a mental health disorder diagnosed by your GP. You can book a longer appointment (20 minutes or more) with your GP to discuss your mental health. Your doctor will ask a few questions you will set goals together, a plan will be written. 

You will be entitled to Medicare rebates for up to ten psychological appointment services each year. Any costs not covered by the Medicare rebate will need to be covered by you or your insurer if you have private health insurance. 

After your first ten appointments, you will need to see your GP again for a mental health plan review. They can refer you for further sessions.

To access a psychologist with an interest in IBD, visit GutSmart Find a Healthcare Professional.

Further information is available at Services Australia Mental health care and Medicare. 

What is the Medicare Safety Net?

If you need to spend a lot of money on out-of-hospital medical appointments or tests, the Medicare Safety Net can help you get more money back from the government for your out-of-pocket expenses. The medical services covered include visits to your GP or a specialist/gastroenterologist, services provided in private clinics and private emergency departments, and many pathology and diagnostic tests.

If you are single, you don’t need to do anything to receive the benefit of higher reimbursement by the government when you reach the Safety Net threshold – it happens automatically. If you are in a couple or family, you will need to register to ensure everyone on your Medicare card is included visit Services Australia How to Register. 

What is the Pharmaceutical Benefits Scheme (PBS)?

Living with IBD can be financially challenging due the ongoing cost of medications. The PBS is an Australian Government initiative to help lower the cost of medication.  You should pay a maximum of $30 for any PBS listed medication (Jan 2023).

To access PBS medications through your pharmacist, you will need a prescription from your GP or specialist. PBS medicines are available to:

• all Australians and concession card holders who have a current Medicare card, 
• visitors from overseas countries with which Australia has a Reciprocal Health Care Agreement, and 
• veterans, war widows and widowers, and dependants who are eligible under the Repatriation Pharmaceutical Benefits Scheme.

If you are an Aboriginal or Torres Strait Islander Australian, you may be able to access more help through the Closing the Gap PBS Co-Payment.

What is the PBS Safety Net?

If you spend a lot on PBS medicines, the PBS Safety Net can reduce your costs after you’ve reached a certain amount in a calendar year (beginning January 1).

Current thresholds (on 1 January 2023):

• $262.80 for concession card holders
• $1,563.50 for general patients.

Before you meet the threshold, each medicine will cost up to:

• $7.30 for concession card holders
• $30.00 for general patients.

After you meet the threshold, each medicine will be:

• free for concession card holders
• up to $7.30 for general patients.

You can reach the threshold sooner by combining what everyone in your family spends on PBS medicines. 

You can ask your pharmacist which medicines will count towards the threshold. You’ll need to keep track of your medicines to know when you’ve reached the threshold. Your pharmacist can assist you with this by printing you a record.

For more information, you can visit Services Australia PBS.

What if I care for someone with a chronic illness or a mental health disorder?

Caring for someone with a chronic condition can be emotionally and financially challenging. Centrelink offers support through:

• Carer Payment or Carer Allowance – if you provide constant care to someone.
• Carer Supplement – an extra yearly payment for some carers.
• Carer Adjustment Payment – a one-off payment for carers of children where a child (under 7 years) is diagnosed with a severe disability or severe medical condition.
• Continence Aids Payment Scheme – if your child or someone you care for has permanent and severe incontinence, a yearly payment can help you buy continence aids for them. As inflammatory bowel disease is a non-neurological condition, you must have a Pensioner Concession Card. 

For more information, you can visit Services Australia Caring for Someone. 

What concession and health care cards are available?

Concession and health care cards can help you get cheaper health services through bulk billing and medicines under the Pharmaceutical Benefits Scheme. 

The types of cards you may be able to access include:

• Health Care Card, 
• Commonwealth Seniors Health Card,
• Pensioner Concession Card,
• Low Income Health Care Card,
• Ex-Carer Allowance (Child) Health Care Card, and
• Foster Child Health Care Card.

Learn more at Services Australia concession and health care cards.

For more information about seeking medical help, Medicare, living with a disability, or caring for someone, please visit Services Australia. 

Insurance

Which private health insurance should I get?

There are plenty of providers of private health insurance in Australia and all offer different levels of cover and benefits. It is important that you compare the funds carefully and read the fine print to make sure that a policy truly meets your specific needs. 

Most insurers let you choose your own specialist and have treatment in a private hospital, or as a private patient in a public hospital. It is important to note that private insurance is only for hospital related costs (for example, hospital admissions, endoscopy, infusions) and may have an out of pocket excess. When selecting private health insurance, be mindful that it will not include:

• outpatient care, such as some specialist or GP visits,
• visits to a public or private hospital emergency department, or 
• subsidise medication costs (although there are occasional inpatient exceptions for off label use of drugs that is probably beyond the scope of this document).

Unless you are a patient in hospital, it also does not cover:

• x-rays or other scans, and
• any pathology tests, including blood tests. 

The internet is a valuable source of information about health insurance for IBD and can help you identify the most suitable providers. Learn more about your options and make a short list of potential providers. Discuss your needs with them directly (by telephone or in person) before deciding on a policy that is best for you. You may experience a 12 month waiting period in coverage for existing illness as part of your policy, but overall you should not pay more for your health insurance because you live with IBD as Australia uses a community rating system. Remember, if you have IBD or another chronic illness that you fail to mention when arranging private health insurance, your policy could be deemed invalid when you need to make a claim. 

If you are eligible, you can claim your Australian Government rebate on private health insurance from your health insurer or from the Australian Taxation Office. 

You can learn more at Services Australia Private health insurance and Medicare. 

The Australian Government have developed a Medical Costs Finder website to help people with private health insurance find and understand costs for medical specialist services across Australia. You can use the website to:

• find typical fees and costs for common medical services, 
• learn what costs you might need to consider before seeking medical treatment, 
• find specialists, and 
• see a typical patient journey for select services. 

Is IBD covered in trauma, total and permanent disability or income protection insurance?

Some insurances are provided with superannuation or can be purchased as stand alone products. Trauma insurance can provide you with financial support if a sudden medical event impacts you and you are unable to work. Some insurers include Crohn’s disease and ulcerative colitis as an eligible event in their Trauma insurance products, but the only way to be certain is to check the specific Product Disclosure Statement.

If you have Income Protection Insurance, it can pay part of your lost income if you are unable to work because of a disability caused by illness or injury. Again this is dependent on the insurer and policy so the only way to be certain is to check the specific Product Disclosure Statement.

Total & Permanent Disability (TPD) and income protection insurance cover is designed provide financial support if you if you have an illness or injury that leaves you totally and permanently disabled and unable to return to a job for which you are suited by training, education, or experience.

Superannuation

Can I access my superannuation to help with my finances?

Superannuation is a long term savings initiative to help fund your retirement. Payments into your superannuation can come from:

• your employer if you have a job, 
• you as an employee or self employed person,
• the government in some cases, or
• you adding funds from the sale of downsizing your home. 

In most cases you will receive the funds when you retire as either a lump sum or superannuation pension. There are some cases where you can receive your superannuation early. 

People living with a disability may be able to apply for early access to superannuation:

• Temporary incapacity: you may be able to access your super or insurance benefits if you are temporarily unable to work, or need to work less house, because of a physical or mental condition.
• Permanent incapacity: You may be able to access your super if you have a permanent physical or mental condition. This type of super withdrawal is sometimes called a ‘disability super benefit’. Your fund must be satisfied that your condition is likely to stop you from ever working again in a job you were qualified to do by education, training or experience.

You can learn more at Services Australia superannuation for people with a disability.

Travel and finances

What should my health insurance cover when I go overseas?

Before you travel, check if you are covered by health insurance in the country you are travelling to. 

It is important to ensure your plan covers potential emergency medical treatment, general medical assistance, evacuation back to Australia, as well as any patient transport within and out of your destination.

You will need to disclose your condition as a pre-existing illness and insurers will consider your condition on a case-by-case basis when determining whether you are eligible for insurance and the cost of the insurance according to risk. 

How do I take my PBS medications overseas?

You may not be able to access your medicines in another country or may find they cost more than in Australia. Before you go:

• make sure you check with the country’s embassy, high commission or consulate to ensure the medicine is legal. 
• If it is legal in the country, get a letter from your GP for the medicine and take it with you. If you can’t do this, print and fill in the Medicine Export Declaration form. Take it with you when you go through customs.
• Leave the medicine in the original packaging. 

For more information, visit Services Australia how to manage your PBS medicine overseas. 

When travelling, make sure you have enough medication for your entire trip, plus more in case of delays. For more information, see Travel and IBD.

It is illegal to take PBS medicines overseas for someone other than yourself or someone you’re travelling with. 

Community support services

CCA have free support groups that you can join. Support group meetings provide a safe and supportive environment where individuals impacted by inflammatory bowel disease can express themselves openly and receive support and understanding from others with similar experiences.

How can my local city council support me?

All local city councils have disability support. Your local city council is likely to have services available to you, which may include:

• community facilities and events that support disability access and inclusion,
• resources and information, 
• employment support, 
• family support and counselling, 
• group programs, 
• home care or basic assistance support, 
• carer support, and 
• home library services. 

You can find and visit the website of your local city council for more information.  

Where can I get financial advice?

Commonwealth Financial Counselling services are available, delivered by community and local government organisations to help people in financial difficulty address their financial problems, manage debt and make informed choices about money in the future.

The services are free and confidential and may include:

• advice and information, 
• advocacy, 
• negotiation, 
• referral, and
• community education.

These services can be accessed through:

• face-to-face meetings, 
• the National Debt Helpline on 1800 007 007 (calls from public phones/mobile phones may be timed and charged at a higher rate), and
• visiting ndh.org.au.   

For more information, please visit Commonwealth Financial Counselling. 

What can I do if I am struggling financially?

If you are experiencing financial hardship, the Salvation Army have services available to help you:

• Financial counselling: free and confidential Moneycare financial service. Contact 1800 722 363 to make an appointment. 
• Be the Boss: free online course to help you get back on top of your money.

More financial resources are available at The Salvation Army financial resources. 

Support for International students

Travelling overseas and navigating a new health care system whilst living with a chronic condition, like IBD, can be challenging in many ways, including financially. There are some support options available to you.

Do I need health cover studying in Australia?

If you are an international student studying in Australia, you must purchase Overseas Student Health Cover (OSHC) before arriving in Australia. Insurers will offer different service inclusions, so it is important to find the right cover for your needs. 

The insurer may cover:

• out-of-hospital medical services (e.g. GP visits),
• in-hospital medical services, 
• public hospital admissions, 
• private hospital/registered day hospital facility, 
• access to a maximum benefit of $300 per calendar year to help you purchase medication, and 
• ambulance services.

Be mindful that you may be required to serve a waiting period, up to 12 months for certain services. You may only be able to claim a maximum amount per prescription, leaving you with out-of-pocket expenses. It is advised you contact health providers directly for information about your individual needs.  

You should also check with your insurer which hospitals are covered under your policy before presenting to a hospital for non-emergency treatment as there may be some out-of-pocket costs. 

For more information on OSHC, please visit Australian Government OSHC resources.

What services might my university offer?

Many universities offer free health and wellbeing checks if you are an international student. You may be able to talk confidentially to a healthcare professional about:

• lifestyle (diet, exercise, sleep), 
• mental health, 
• sexual health, or 
• accessing health services in Australia. 

They may also check your glucose and blood pressure levels. 

Most universities will offer access to a disability coordination officer, who can assist you with:

• finding your needs to make the introduction into study easier,
• putting you in touch with other students who have similar support requirements,
• information about scholarships and grants,
• pre-enrolment advice,
• special entry schemes, and
• application and enrolment advice.

It is important you contact your university to see what services are available to you.