Emergency medical treatment

If the client meets all qualifications, they may be able to receive a Special Needs Grant towards the cost of emergency medical treatment including doctor's fees, prescription charges or hospital care.

Special Needs Grants cannot be used to 'top up' any shortfall when the medical treatment is as a result of an accident that has been accepted by ACC. However, when travel is required, see Health travel costs.

Where the client is liable for the part user-charges of any medical expenses, grants are limited to the amounts after the deduction of subsidy from the Community Services Card or any amount paid by Disability Allowance.

Special Needs Grants should not generally be approved for emergency treatment in a private hospital, unless there is a good reason why they cannot be transferred to a public hospital, such as being in critical condition.

Where the client needed emergency medical treatment and was unable to seek prior Work and Income approval for the service. You can consider paying the account if the client has no other way of paying (for example through instalments) or their current budget does not leave room to meet this unexpected cost.

You can make a grant for this purpose to each family member of an immediate family.

There may be situations where a client needs emergency medical treatment and is unable to make arrangements for repayment of the cost of the treatment, as they are required to pay for this immediately. You can consider a non-recoverable Special Needs Grant as a reimbursement for the actual costs incurred where the client is required to make immediate payment for the visit.

Note the emergency medical treatment must be a situation that could not have been foreseen or predicted.

A client has an appointment with their health practitioner at 4.30pm on a Friday as they require immediate treatment. The client is unable to seek Work and Income approval for payment prior to the treatment. The client pays for the account, as the health practitioner/surgery requires immediate payment but they have no money left for their normal daily expenses.

The client contacts the service centre on Monday for financial assistance. A Special Needs Grant can be considered in this case as a reimbursement.

A client with a serious illness goes to their health practitioner on Monday, however, by Friday their condition has got worse and the client needs to make an emergency appointment to see their health practitioner again.

The client pays for the account, as the health practitioner/surgery requires immediate payment but they have no money left for their normal daily expenses.

The client contacts the service centre on the following Monday for financial assistance. A Special Needs Grant can be considered in this case as the client did not know their condition would deteriorate and that they would require an additional appointment. A reimbursement for the Friday appointment with their health practitioner can be considered as an emergency medical treatment Special Needs Grant.

Unless exceptional circumstances exist, the maximum amount payable towards emergency medical treatment is $300.

Special Needs Grants for this purpose are:

• non-recoverable and
• not restricted to 1 payment for the same or similar purpose in any 52 week period

Deduct any health-related subsidy and/or insurance payments from the total amount required.

For more information see:

• Qualifications
• Health travel costs
• Exceptional circumstances