Practical information about funding for prosthetics and orthotics

People are often concerned about the costs involved in getting a prosthetic or orthotic. In Australia, there are a number of different funding schemes and it can be easy to get confused, and difficult to figure out what funding you might be eligible to receive.

Your Prosthetist or Orthotist will discuss funding with you as part of your consultation process. It should be noted however that as the majority of amputations are due to contributing medical conditions such as diabetes, vascular diseases and cancer, a prosthetic will generally be covered by funding from the public health system or if you are eligible, the National Disability insurance Scheme (NDIS).

This section of the website gives you a quick run-down on funding available for prosthetics and orthotics, and the NDIS, as well as links to more information and support.

Prosthetics Funding

In a nutshell, the following categories apply to prosthetic funding:
  • If you lost your limb due to disease or illness, you will most likely be covered by the Queensland Government’s Artificial Limb Service (QALS) or the NDIS if you are under the age of 65.
  • If you lost your limb in an accident at home or during recreation, and there is no compensating body, then the public health system or the National Injury Insurance Scheme (NIIS) will cover the cost of the prosthetic limb/s. Note: The NIIS is still in development and in the meantime, funding will be provided by the NDIS.
  • If your amputation was due to trauma, such as a motor vehicle or workplace accident, and compensation is identified as a possibility, the insuring organisation, e.g. as the Traffic Accident Commission (TAC) or WorkCover, will most likely fund your prosthesis and medical care as part of your rehabilitation.
  • Veterans who either lost their limb as a result of injuries received while serving in the Australian Army, Navy or Airforce, or who have a Gold Card, will have their prosthesis paid for by the Department of Veterans Affairs (DVA) or the Defence Force.
  • Most Private Health Insurance companies do not allocate funding for prosthetics, however it is worth checking with your insurer if you are uncertain, as they may cover partial costs.

Talk to your Prothetist for more information.

The Australian Government's National Disability Insurance Scheme (NDIS) provides support to people with disability, their families and carers. Under the NDIS, all Australians under the age of 65 who have a disability that is likely to be permanent and significant are provided with the reasonable and necessary supports they need to live an ordinary life. This includes prosthetics and, in some cases, orthotics.
These are the steps involved in becoming an NDIS participant and getting funding approved for a prosthesis:
  • 1
    Contact NDIS

    and request a NDIS registration form. Once you have received the form, complete it and return it to the NDIS.

  • 2
    Arrange your planning meeting

    Once your registration form has been submitted, the NDIS will contact you to arrange a planning meeting with your Local Area Coordinator (LAC).

  • 3
    Meet with your prosthetist

    IMPORTANT: Before your meeting with the NDIS' Local Area Coordinator, make sure you meet with your prosthetist. Your prosthetist will advise you of the funding required. The goals you set for yourself in your NDIS plan will determine the type of prosthesis NDIS may fund.

  • 4
    Meet with your Local Area Coordinator

    You then meet with your NDIS Local Area Coordinator and develop a proposed plan requesting the funding and correct allocation required for the life of your plan (usually 12-months).

  • 5
    Visit your Prosthetist for a functional assessment

    Once you received a copy of your plan from NDIS, visit your Prosthetist for a functional assessment and quote that he will submit for approval to NDIS. At this point, there will be funding available for consumables like liners/socks to see you through until the approval comes through.

  • 6
    NDIS approval

    Once NDIS approval is received, you can commence the process of having a prosthesis designed, manufactured and fitted.

Visit the NDIS website

Orthotics Funding

In Queensland the following options are available for orthotics funding:
  • Queensland Health’s Medical Aid Subsidy Scheme (MASS) – this is a subsidy scheme for orthotics and therefore the patient is required to pay any shortfall.
  • Department of Veterans’ Affairs (DVA) – DVA pay for orthotics for eligible serving and former Australian Defence Force members. An out-of-pocket contribution may be applicable, depending on the type of device required.
  • Private Health – Most private health insurance companies do not allocate funding for orthotics, however it is worth checking with your insurer if you are uncertain, as they may cover partial costs.
  • NDIS – If you are under 65, have a permanent disability and require support for the rest of your life, the NDIS may cover the cost of orthotics.
  • Traffic Accident Commission (TAC) or WorkCover – If your injury was due to trauma, such as a motor vehicle accident or workplace accident, and compensation is identified as a possibility, the insuring organisation (TAC or WorkCover) will most likely fund your orthoses and medical care as part of your rehabilitation.

Talk to your Orthotist for more information.

The Australian Government's National Disability Insurance Scheme (NDIS) provides support to people with disability, their families and carers. Under the NDIS, all Australians under the age of 65 who have a disability that is likely to be permanent and significant are provided with the reasonable and necessary supports they need to live an ordinary life. This includes prosthetics and, in some cases, orthotics.
These are the steps involved in becoming an NDIS participant and getting funding approved for a prosthesis:
  • 1
    Contact NDIS

    and request a NDIS registration form. Once you have received the form, complete it and return it to the NDIS.

  • 2
    Arrange your planning meeting

    Once your registration form has been submitted, the NDIS will contact you to arrange a planning meeting with your Local Area Coordinator (LAC).

  • 3
    Meet with your prosthetist

    IMPORTANT: Before your meeting with the NDIS' Local Area Coordinator, make sure you meet with your prosthetist. Your prosthetist will advise you of the funding required. The goals you set for yourself in your NDIS plan will determine the type of prosthesis NDIS may fund.

  • 4
    Meet with your Local Area Coordinator

    You then meet with your NDIS Local Area Coordinator and develop a proposed plan requesting the funding and correct allocation required for the life of your plan (usually 12-months).

  • 5
    Visit your Prosthetist for a functional assessment

    Once you received a copy of your plan from NDIS, visit your Prosthetist for a functional assessment and quote that he will submit for approval to NDIS. At this point, there will be funding available for consumables like liners/socks to see you through until the approval comes through.

  • 6
    NDIS approval

    Once NDIS approval is received, you can commence the process of having a prosthesis designed, manufactured and fitted.

Visit the NDIS website

The Australian Government's National Disability Insurance Scheme (NDIS) provides support to people with disability, their families and carers. Under the NDIS, all Australians under the age of 65 who have a disability that is likely to be permanent and significant are provided with the reasonable and necessary supports they need to live an ordinary life. This includes prosthetics and, in some cases, orthotics.
These are the steps involved in becoming an NDIS participant and getting funding approved for a prosthesis:
  • 1
    Contact NDIS

    and request a NDIS registration form. Once you have received the form, complete it and return it to the NDIS.

  • 2
    Arrange your planning meeting

    Once your registration form has been submitted, the NDIS will contact you to arrange a planning meeting with your Local Area Coordinator (LAC).

  • 3
    Meet with your prosthetist

    IMPORTANT: Before your meeting with the NDIS' Local Area Coordinator, make sure you meet with your prosthetist. Your prosthetist will advise you of the funding required. The goals you set for yourself in your NDIS plan will determine the type of prosthesis NDIS may fund.

  • 4
    Meet with your Local Area Coordinator

    You then meet with your NDIS Local Area Coordinator and develop a proposed plan requesting the funding and correct allocation required for the life of your plan (usually 12-months).

  • 5
    Visit your Prosthetist for a functional assessment

    Once you received a copy of your plan from NDIS, visit your Prosthetist for a functional assessment and quote that he will submit for approval to NDIS. At this point, there will be funding available for consumables like liners/socks to see you through until the approval comes through.

  • 6
    NDIS approval

    Once NDIS approval is received, you can commence the process of having a prosthesis designed, manufactured and fitted.

Visit the NDIS website

Important Links

Here are some links to associations, organisations which support people requiring prosthetics and orthotics.
Funding Bodies

Ability Prosthetics and Orthotics is a registered member of the Australian Orthotic Prosthetic Association (AOPA), NDIS, Queensland Artificial Limb Service (QALS) and Department of Veterans Affairs.