Health insurance for physiotherapy

Medicare will only cover the physio costs you incur as an inpatient in a public hospital.

When you take out extras with health insurance you can receive benefits towards the cost of physiotherapy. Plans start from around $3 per week

Compare extras options for physiotherapy

Below are a few funds from Finder partners who cover physiotherapy sessions. We've displayed the yearly limit and they have a 2 month waiting period. They also include other benefits such as dental, optical or chiro.

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Name	Product	Physiotherapy cover	Annual limit	General Dental	Chiropractic cover	Remedial Massage	Price Per Month	Hide CompareBox
HCF Starter Extras			$150				$12.60		Go to Site More Info	Compare	loading Fetching your data...
ahm black 50 saver			$300				$12.70		Go to Site More Info	Compare	loading Fetching your data...
health.com.au Pulse 50 Extras			$150				$20.86		Go to Site More Info	Compare	loading Fetching your data...
AAMI Starter Extras			$250				$21.04		Go to Site More Info	Compare	loading Fetching your data...
Suncorp Starter Extras			$250				$21.04		More Info	Compare	loading Fetching your data...
Peoplecare Simple Extras			$300				$24.90		Go to Site More Info	Compare	loading Fetching your data...
Medibank Healthy Start Extras			$500				$25.95		Go to Site More Info	Compare	loading Fetching your data...
Qantas Basic Extras			$350				$31.27		Go to Site More Info	Compare	loading Fetching your data...

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Just refine your search by 'physiotherapy' on the results screen to see your options.

What physiotherapy expenses are covered?

Health funds cover physio on extras policies, although the benefit amounts provided will depend on the level of cover you choose. For example, a basic extras policy may only provide limited benefits or even exclude physio altogether. However, if included an extras policy will generally cover the physio-related services listed below.

Common physiotherapy services you can claim for

Be aware that there are certain physio-related items that are not commonly covered by private health funds. These can include foam rollers, trigger balls and sports tape. Also keep in mind that services and items that can be claimed may differ between health funds and individual extras cover, so make sure to compare the features of each policy closely before making a purchase.

What amount will I be able to claim back?

Depending on the health fund and extras policy you choose, your benefit amount for physio services may be calculated in the following ways.

• Set benefit. This means that your rebate will take the form of a fixed dollar amount for claims on eligible services, such as $40 or $50.
• Percentage benefit. Alternatively, your rebate may be calculated as a percentage of the total fee charged for the service, for example 50% or 75%.

It is also worth remembering that an annual limit will apply to the maximum rebate you are able to claim per person.

Does Medicare cover any physiotherapy services?

Medicare can provide benefits for physio-related treatment in the following circumstances.

• Public hospital admittance. Medicare provides some benefits for public hospital patients who need inpatient physio treatment or rehabilitation.
• Chronic Disease Management program (CDM). Medicare may also cover certain physio-related services if they are part of a CDM recommended by at least two allied health professionals and a GP. Eligible chronic diseases can include arthritis, diabetes, cancer, stroke and musculoskeletal conditions.

However, all other out-of-hospital physiotherapy costs are not covered by Medicare and you will need to rely on your private health insurance.

Who can benefit from cover?

No matter how active you are or what life stage you are at, there are plenty of reasons why you might be able to benefit from private health insurance cover for physiotherapy:

• If you have developed a movement disorder of any kind.
• If you are restricted by a chronic illness.
• If you are recovering from an injury.
• If you play a sport with a risk of physical injury.

How do I lodge a claim with my health fund?

There are several ways you can claim physiotherapy on your health insurance, but keep in mind that your health fund may not offer all of the following claim options.

• On the spot. Use your membership card to submit your claim electronically through HICAPS when you visit your physio.
• Online. Use your health fund’s online claims service to submit the details of your claim, including a receipt from your physio.
• Via an app. Many health funds offer claims apps that allow you to submit a photo of your receipt and claim.
• Via email, fax or post. Fill out a claims form, attach a copy of your receipt and email, fax or post it to your health fund.
• In person. If your fund operates bricks and mortar branch, visit one of these in person to submit your receipt and claim.

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