GEELONG OSTOMY  Inc

P.O Box 1069 Grovedale Victoria Australia 3216

Ph: 03 5243 3664  Fax: 03 5243 6335  e-mail: goinc@geelongostomy.com.au


STOMA APPLIANCE SCHEME

Until 1975 all stoma appliances had to be purchased by the user, and, only as a result of considerable effort and intensive lobbying by the Australian Council of Stoma Associations (ACSA), did the Federal Government agree to fund the Stoma Appliance Scheme.

The Stoma Appliance Scheme provides assistance to all Australian residents who have undergone stomal surgery and is a national program of the Pharmaceutical Benefits Scheme. The Commonwealth Government fully subsidises stoma medicines and appliances used by entitled ostomates.  The Australian Council of Stoma Associations (the Council) represents the stoma associations on matters affecting the operation of the Stoma Appliance Scheme.  Individual associations purchase and issue supplies to their members and are reimbursed by the Commonwealth Government.

Following is a copy of the Medicare Australia Brochure updated March 2006.

Stoma Appliance Scheme

The Stoma Appliance Scheme (the Scheme), subsidised by the Australian Government, provides stoma related products (medicines and appliances) free of charge to members of stoma associations.  There are approximately 30,000 members nationally who receive products under the Scheme through approved volunteer stoma associations.

The choice of products which you should use is guided by a stomal therapy nurse who is specifically trained to advise you on their use following colostomy, ileostomy or urostomy surgery.

Who is eligible for the Scheme?

The Scheme provides assistance to all Australian residents that have undergone either a temporary or permanent surgically created body opening (stoma), usually in the abdominal region. This artificial opening allows the removal of body waste when you have lost normal bowel or bladder functions as a result of disease, injury, birth defects or other causes.

How can I obtain subsidised stoma products?

To receive subsidised stoma products you must hold an  Entitlement Card supplied by Medicare Australia through any one of the 22 stoma associations throughout Australia.  Your stomal therapy nurse will help you join a stoma association or alternately, you can contact one of the associations Listed in this information sheet.  To become a members of a stoma association, you will be required to pay a small fee to assist the association with the cost of distributing stoma products and other valuable services.

What stoma products am I entitled to?

The Scheme's Schedule (the Schedule) lists products that have been approved by the Department of Health and Ageing to be issued to eligible members.  The Schedule determines the maximum quantity that you can receive per month, the price of the product and whether there are any restrictions.

The Department of Health and Ageing updates the Schedule four times a year with new products, deleted products and any variations to products already listed. If you require a product not listed on the Schedule, you will be required to pay the full price; it will not be subsidied by the Government.

The schedule can be obtained from either your stoma association or on the Department of Health and Ageing's website, www.health.gov.au , type "Stoma Appliance Scheme" into the search engine.

What if I need more than the monthly maximum of stoma products allowed?

There are provisions under the Scheme for you to receive additional supplies where the monthly allocation does not meet your ongoing needs.

To obtain more than the maximum monthly allowance from your association, Medicare Australia require a signed medical certificate obtained from your stomal therapy nurse or general practitioner clearly stating the reason for the need for additional products and specifying the item/s and quantities required. This certificate should be passed on to your local stoma association who will forward it to Medicare Australia on your behalf.  Please note that the medical certificate is currently only for six months.

What if I need stoma products while I am on holiday?

If you are travelling with in Australia you can produce your Entitlement Card at any stoma association which can supply stoma products to you as a temporary resident in their area.  Associations prefer you to make prior arrangements with them to ensure that they have your particular products in stock for you.  An advance supply of your monthly allowance is also permitted to cover holidays.

You are able to order your products for two months in advance.  This can benefit people going on holidays either in Australia or overseas.  If you are travelling overseas for longer than two months, you should speak with your association to discuss what options are available to you.

Stoma products are not available to Australian citizens who reside outside Australia.

Who develops guidelines for the Stoma Appliance Scheme?

The Department of Health and Ageing develops the guidelines and policies for the Stoma Appliance Scheme.  Medicare Australia administers the Scheme and has responsibility for the process and payment of claims lodged for payment by the stoma associations.

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