Can acupuncture fees be claimed with health insurance? Learn about the type of policy you need and the costs that are covered.
Acupuncture is a safe, traditional Chinese health treatment in which needles are inserted into your body’s pressure points to bring pain relief and to treat medical conditions. In Australia it's recognised as a viable treatment and can be included in extras cover for out of hospital services.
Compare extras health insurance offered by 30+ funds
If you've got an extras policy that includes acupuncture then you can claim benefits for consultations performed by a licensed practitioner. Extras health insurance is typically available as a stand alone policy or a combined hospital and extras policy from most private health funds.
There is no set amount that you’ll be covered for, as benefit amounts vary depending on the health fund you are with. Check with your health fund to find out how your benefit will be paid and how much you can claim each year.
Private health funds will pay a benefit only if you use the services of a qualified acupuncturist. An acupuncturist must have completed a bachelor's degree in Australia, for example a Bachelor of Health Science (Acupuncture), or an overseas equivalent.
The degree must comply with the Australian Guidelines for Traditional Chinese Medicine Education. Importantly, health funds will not recognise qualifications if your acupuncturist has completed units of study as part of a master’s degree.
*The policies listed in this table are extras only. However, in most cases these can be combined with hospital cover. Information last verified June 2017. Always read the PDS before buying a policy.
|Health fund||Extras policies and annual benefit limits*||Waiting periods|
|Cessnock District Health Fund|
|Frank Health Insurance|
|Health Care Insurance|
|Latrobe Health Services|
|Mildura Health Fund|
|Phoenix Health Fund|
|Queensland Country Health Fund|
|St. Lukes Health|
|Doctors Health Fund|
|Reserve Bank Health Society|
|Teachers Health Fund|
*The policies listed in this table are extras only. However, in most cases these can be combined with hospital cover.
- Scope of cover. Some health funds pay a benefit for acupuncture procedures but don't cover other alternative therapies.
- Certified practitioner. Ensure you visit an acupuncturist who is recognised by your fund so you can claim for the treatment. This requirement may also apply to other alternative therapy practitioners.
- Ongoing treatment. funds such as nib only pay a benefit for consultations. Ongoing treatment by an acupuncturist may lead to additional out-of-pocket expenses.
- Treatment frequency. Policies, such as HCF Top Extras cover won’t pay a benefit if you have more than one therapy service provided by the same practitioner in the same day.
- Waiting periods. Most health funds set a two month waiting period before you can claim acupuncture benefits, although if treatment is for a pre-existing medical condition the waiting period is 12 months.
People suffering from chronic back pain, dental or jaw pain and nausea relating from pregnancy or chemotherapy can benefit from acupuncture treatment.
The World Health Organisation (WHO) has also recognised that acupuncture can lead to a positive outcome for neurological, respiratory, digestive, musculoskeletal and eye conditions.
Funds may only reimburse you a percentage of the cost of your acupuncture treatment. Your out-of-pocket expenses are called a gap payment, which is the difference between what you pay the acupuncturist and what you get back from the fund.
The most straightforward ways to claim an extras service like acupuncture are:
- Instantly with HICAPS. Simply swipe your insurance membership card at the acupuncturist’s office (if this service is provided) and your insurance claim will be processed immediately and the refund deposited into your bank account.
- Online. Navigate to the member portal of your fund’s website and follow the prompts to lodge your claim.
Although acupuncture, along with traditional Chinese medicine, is one of the oldest health treatments in the world, in Western society, the benefits of alternative medicines are still being explored. More funds are including natural therapies within the scope of covered extras every year. Compare policies at finder.com.au so you can find the right policy for you.
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