Health insurance for orthotics

Health insurance for orthotics

What costs do health funds cover for orthotics?

If you require treatment from an orthotist or you need orthotics to improve your mobility, the cost of treatment can be quite expensive. However, if you have private health insurance, your health fund may cover some or all of the costs.

Cover for orthotics is typically included in an extras or general treatment policy, so let’s take a look at what sort of benefits are available and how to find a policy that suits your needs.

Which Australian health funds cover orthotics?

Health fundExtras policies and annual benefit limits*Waiting periods
HIF health insurance
  • Premium Options. $240 per person
  • Super Options. $200 per person
  • 12 months
Health Care Insurance
  • Premier Extras. $200 per person
  • 2 months
teachers health fund
  • Restricted health fund
  • Top Extras. $60 per person
  • 2 months
AHM health insurance
  • Family Extras. $150 per person
  • Super Extras. $200 per person
  • 12 months
Australian Unity
  • Gold Extras. $350 per person
  • Platinum 80% Extras. $600 per person
  • 12 months
GMHBA health fund
  • Gold Extras. $250 per person
  • Silver Extras. $200 per person
  • 12 months
HCF health insurance
  • Gold Extras. $200 per person
  • Platinum Extra. $250 per person
  • 12 months
nib health insurance
  • Top Extras. $400 per person
  • Core Family Extras. $200 per person
  • Core Young at Heart Extras. $200 per person
  • 2 months
Transport Health insurance
  • Top Extras. $200 per person
  • 12 months

*The policies listed in this table are extras only. However, in most cases these can be combined with hospital cover.

Health fundExtras policies and annual benefit limits*Waiting periods
ahm
  • Family Extras. $150 per person
  • Super Extras. $200 per person
  • 12 months
Australian Unity
  • Gold Extras. $350 per person
  • Platinum 80% Extras. $600 per person
  • 12 months
Bupa
  • Platinum Extras. $1,200 per person
  • Gold Extras. $1,000 per person
  • Silver Extras. $800 per person
  • 12 months
CUA Health
  • Total Extras. $400 per person
  • Classic Extras. $210 per person
  • 12 months
GMF
  • Complete Extras. $500 per person
  • Mid Extras. $450 per person
  • Lite Extras. $450 per person
  • 12 months
GMHBA
  • Gold Extras. $250 per person
  • Silver Extras. $200 per person
  • 12 months
HBF
  • Flexi Extras Plus. $500 per person
  • Flexi Extras Mid. $400 per person
  • Flexi Extras. $300 per person
  • Saver Flexi Extras Plus. $250 per person
  • Saver Flexi Extras Mid. $200 per person
  • Saver Flexi Extras. $150 per person
  • 12 months
HCF
  • Gold Extras. $200 per person
  • Platinum Extras. $250 per person
  • 12 months
Health Care Insurance
  • Premier Extras. $200 per person
  • 2 months
hif
  • Premium Options. $240 per person
  • Super Options. $200 per person
  • 12 months
Latrobe Health Services
  • Premier Gold, Family Care Gold. $600 per person
  • Premier Silver, Family Care. $300 per person
  • Premier, Premier Plus. $300 per person
Medibank
  • Growing Family Extras Only. $300 per person
  • Top Extras. $200 per person
  • 2 months
Mildura Health Fund
  • Five Star Extras. $650 per person
  • Ancillary Plus. $540 per person
  • Basic Ancillary. $390 per person
  • 12 months
nib
  • Top Extras. $200 per person
  • Family Extras. $200 per person
  • Young at Heart Extra. $200 per person
  • 2 months
onemedifund
  • Extras Plus. $250 per person
Peoplecare
  • Premium Extras. $700 per person
  • High Extra. $500 per person
Queensland Country Health Fund
  • Premium Extras. $600 per person.
  • Essential Extras. $400 per person.
  • Young Extras. $500 per person.
  • 2 months
St. Lukes Health
  • Super Extras. $200 per person
  • 12 months
Transport Health
  • Top Extras. $200 per person
  • 12 months
ACA Health
  • Restricted health fund
  • Complete Ancillary. $400 per person
  • 12 months
Defence Health
  • Restricted health fund
  • Premier Extras. $300 per person
  • Value Extras. $250 per person
  • 12 months
Navy Health
  • Restricted health fund
  • Premium Extras. $300 per person
  • Healthy Living Extras. $200 per person
  • 2 month
RT Health
  • Restricted health fund
  • Premium Extra. $175 per person
  • Smart Extras. $140 per person
  • 12 months
Teachers Health Fund
  • Restricted health fund
  • Top Extras. $60 per person
  • 2 months
TUH
  • Restricted health fund
  • Comprehensive Extras. $360 per membership year
  • 2 months

*The policies listed in this table are extras only. However, in most cases these can be combined with hospital cover.

Compare health insurance for orthotics

What are orthotists and orthotics?

An orthotist is an allied health professional who can, according to the Australian Orthotic Prosthetic Association, “Assess and treat the physical and functional limitations of people resulting from illnesses and disabilities, including limb amputations.” Orthotists can prescribe, design, fit and monitor the performance of orthotic and prosthetic devices.

Orthotics, which are also called orthoses, are specially designed braces, appliances and inserts that can be fitted to the body. There are orthoses available for knees, ankles and feet – for example, shoe inserts – plus orthoses to protect fractures and spinal orthoses. These appliances are used to:

  • Assist in rehabilitation
  • Control biomechanical alignment
  • Correct deformities
  • Reduce pain
  • Increase mobility and independence
  • Prevent injury or protect an injury while it heals

Are orthotists the same as podiatrists?

Although there are some similarities between the work they do, orthotists and podiatrists are two very different types of health professionals.

  • Orthotists. Work exclusively with orthoses, which are devices fitted externally to the body to treat a wide variety of physical limitations resulting from illnesses, disabilities and deformities. In some cases this involves using orthotics to treat abnormalities, prevent injuries and improve normal functions of the lower limbs and feet.
  • Podiatrists. Concentrate solely on the disorders of the lower limbs. Treatment from a podiatrist may sometimes involve the fitting of orthotic devices, but it can also involve more palliative treatment such as the removal of calluses, warts, corns and ingrown toenails.

Are orthotic services covered by health insurance?

The good news is that many Australian private health funds include cover for orthotics as part of some extras policies. However, you will usually need to take out a comprehensive extras cover in order to receive benefits for orthotics, as it is commonly excluded from basic extras policies.

It is also important to be aware that health funds classify orthotics differently. Some funds will list orthotics in its own section with a single annual benefit limit you can claim for orthoses and treatment by an orthotist. Other health funds will combine orthotics with other appliances under a health aids with a shared annual benefit limit.

Examples of orthoses you may be able to claim for

What should I be aware of when claiming for orthotics?

  • Certified supplier. Before you lodge a claim for orthotic appliances, be aware that the items will need to be provided by a registered orthotist, orthotic supplier or podiatrist. Make sure your health fund will cover your orthotics purchase from your chosen supplier before you pay for your appliance.
  • Waiting periods. Familiarise yourself with the different waiting periods that apply to orthotics under your policy. Some health funds will impose a blanket waiting period on all orthotics claims, such as 12 months. However, some health funds will impose separate waiting periods on the repair, maintenance, hire and replacement of orthotic equipment, so be sure to check the fine print before taking out cover.
  • Annual benefit limits. Check the limits that apply to your cover. In addition to an annual benefit limit for orthotics, your health fund may impose limits on the amount it will pay for specific orthotic devices, or it may agree to cover a certain percentage of your bill for specific orthotic appliances. Remember that any annual limit listed may also include any benefits you receive for other health aids and appliances.

Final things you might want to know about orthotics

Compare comprehensive extras policies and get a quote from an adviser

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Richard Laycock

Richard is the Insurance Editor at finder, and has been wrangling insurance Product Disclosure Statements for the last 4 years. When he’s not helping Aussies make sense of the fine print, he can be found testing the quality of Aperol Spritzes in his new found home of New York. Richard studied Journalism at Macquarie University and The Missouri School of Journalism, and has a Tier 1 certification in General Advice for Life Insurance. He has also been published in CSO Australia and Dynamic Business.

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