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Department of Health

CAPS - Eligibility

CAPS Eligibility

You may be eligible for CAPS if you are an Australian citizen or permanent resident 5 years of age or older and you have permanent and severe loss of bladder and/or bowel function caused by:

OR

  • an eligible other condition and you have a Centrelink or Department of Veterans’ Affairs Pensioner Concession Card, either as the primary card holder or as dependant of a card holder.
CAPS definition of ‘permanent and severe incontinence'

Permanent and severe incontinence is defined as the frequent and uncontrollable, moderate to large loss of urine or faeces which impacts on a person's quality of life and which is unlikely to improve with medical, surgical or clinical treatment.

How to get a Centrelink Pensioner Concession Card

Cardholders can access Australian Government health concessions and get help with the cost of living by reducing the cost of certain goods and services.

For questions regarding eligibility for a Centrelink Pensioner Concession Card please contact Centrelink on 132 300 or visit a Centrelink - Human Services service centre.

People not eligible for CAPS

You’re not eligible for the Continence Aids Payment Scheme (CAPS) if:

  • you’re an Australian Government-funded aged care recipient who is:
    • an aged care home resident and your provider is required to pay for your continence aids, or
    • a home care package recipient and your care plan includes continence aids
  • you’re eligible for assistance with continence aid products under the Department of Veterans’ Affairs (DVA) Rehabilitation Appliances Program (RAP)
    • you are always eligible for RAP assistance if you have a DVA Gold Card, and may be eligible for RAP assistance if you have a DVA White Card
  • you have a funded package of support from the National Disability Insurance Scheme (NDIS) that includes continence aids
  • your incontinence:
    • is temporary
    • can be treated with other methods such as pelvic floor exercises or bladder retraining, medicine or surgery, or
    • is limited to night time bed wetting
  • you’re serving a prison sentence
  • you’re an Australian citizen or permanent who has resided outside Australia for 3 continuous years.
Reviews of your CAPS eligibility

People with permanent and severe incontinence should have a continence management plan in place with their health professional.

Children 5 to 15 years of age should have their continence reassessed at least every 2 years and all other applicants should have a regular review of their continence needs with their health professional.

Reviews of a client's continence needs should be negotiated and agreed between the client and their health professional.

CAPS clients must promptly notify Medicare on 132 011 of any change in their circumstances that affects their eligibility and, from time to time, may be asked to confirm their eligibility for CAPS.

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