Enable is a NSW government scheme that covers the major portion of the cost of compression garments for clients with lymphoedema, lipoedema and mixed or venous oedemas. It assists with the cost of 2 sets of garments per body part affected every 6 months
Enable’s purpose is to encourage individuals to replace their garments regularly. This has been shown to significantly reduce the impact of lymphoedema on your everyday life and prevent deterioration over time.
You do not qualify for Enable if you have an aged care package, nor if you have applied for an aged care package. You can qualify if you are on NDIS, depending on the cause of your lymphoedema.
If you are not a pensioner or part pensioner, your garments need to cost more than $800 per year for you to qualify.
How much will I have to pay?
The cost to you depends on your circumstances:
If you are a pensioner the yearly copayment to Enable is $100.
If you are not a pensioner you will be required to pay 20% of the cost.
If you are not a pensioner and the annual cost of garments is less than $800 you will not qualify for assistance.
You will of course have to also pay your therapist for your appointments. (Although if you have a CDM plan from your GP it will help with this cost.)
What is the process to apply?
Your therapist can provide you with a copy of the application form or you can apply using the online resources at:
https://www.enable.health.nsw.gov.au/forms/enable-application-form/enable-application-form
You can print out this form yourself, fill in and return to Enable.
Initial Application
The process is straightforward but involved:
You and your therapist need to apply at the same time. ( within a few weeks of each other )
You send your application directly to Enable, by post or online. This contains personal information and is not seen by your therapist. ( Please keep a copy in case you need to prove you submitted it on this date).
If you have not needed to submit a tax return you do not need to supply all your details, just say that you have not needed to submit a tax return and why.
Your therapist will document in their part of the application that you have:
- A diagnosis that meets the requirements of funding,
- That you are impacted or that your function is at risk of being impacted by your lymphoedema
- Lymphoedema that is stable and ready for garments.
- Trialed the garments and found that they were effective.
- Are compliant with wearing your garments,
- These are the garments that are best for you and why
The therapist must also:
- Provide quotes with the application,
(These quotes apply to a specific supplier. If you decide on an alternative garment / supplier after the therapist has completed an application you will need to be measured again and quotes obtained.)
- State the date of the review when this assessment was made.
- Give you a copy of their application.
Enable will:
- Contact you immediately to say that they have received your request,
- Confirm with you in about one month’s time to let you know your application has been approved.
The money is not made available immediately
When the first purchase order is ready to be issued and once a year thereafter, you will receive an invoice for your portion of the cost of the garments. ( that is for one years supply of garments ) Once you have paid this you will receive a purchase order and notification that your first set of garments have been ordered.
This is where most of the confusion happens. There are 2 options depending on what is being ordered for you:
1 – Stocked Garments
If your therapist has ordered a stock item they can tick the box for your garments to be delivered directly to you. You should receive them straight away. You will still need to see your therapist, within the next few months, to check the garment fit and suitability and discuss your next application. ( allow at least 2 months prior to when your next approval is due.)
2 – Custom Garments and Re-measures
Usually your therapist ticks the box that says that the client needs to be remeasured prior to the order being fulfilled. Your garments will not be delivered until you see your therapist for a ‘re-measure’, so do this promptly.
A re-measure ensures that the garments you get are the right size for you now, as your size and shape can change while you are waiting. Clients sometimes state that they want ‘one just the same’ and ‘do I really need a re-measure’? Unfortunately, an old comfortable garment is not always a good indicator of what is best for you now.
Your therapist will also use this opportunity to discuss alternatives for the next request to Enable. She will discuss new garments and developments in fabric as well as any extra features that will make your garments more comfortable and effective.
Once “ in the system” and if you and your therapist keep on top of the process, you will receive a new purchase order every 6 months.
You will be asked to resubmit your application every 2 years. This is mostly to confirm that your financial situation has not changed.
Bear in mind that any change after a purchase order is issued will result in about a month’s further delay, due to your therapist having to request new quotes, resubmit the application and then for Enable to do their administration.
If required, your therapist will usually recommend making a change to the next application, rather than delay the one that is already approved.
Choosing the right garment
Each brand and supplier has a unique measuring system. Your therapist is experienced in measuring Jobst, Medi, Haddenham, ETO, TSL, Second skin, Sigvaris, Mobiderm and Bioflect.. They will choose the best option for you, based on your swelling and ability to don and doff your garments. ( They also know all the tricks of the trade to help you do this )
The emerging diversity in the marketplace is constantly under surveillance by your therapists. They keep abreast of the developing technologies and designs for compression garments and are open to conversations with you.
Some garments are not available through the Enable scheme as they may not give guaranteed therapeutic levels of compression.( eg Bioflect)
Assessing your new garments
Unless you are an ‘old hand’ and your oedema is very stable, your therapist will want to see you in your new garments shortly after they arrive. This is to make sure they fit and work well. Sometimes there are manufacturing faults or the prescription has been misunderstood. This is the time to address these issues, as most companies will correct the fault if alerted promptly..
Getting the best value for money – 2 for 1
Lastly, and this is important, your co-payment is made once per year and assumes you will be applying for 2 sets of garments.
If you have made a co-payment, make sure you follow through with the process and get your second set of garments in 6 months time. Otherwise you have paid double what you needed to!
Act early and act promptly
Enable will not pay retrospectively for garments you bought before applying to the scheme. Work in coordination with your therapist in beginning your account with Enable.
In summary
To progress your treatment and get a better outcome, follow your therapist’s advice and replace your garments every 6 months, when the funding becomes available. If you need intensive therapy, we recommend you receive this just prior to measuring for your new set of garments. This means your garments can be ordered to fit the new you. 🙂