Health insurance for physiotherapy

Get cash back for your physiotherapy costs with extras insurance

If you are suffering from muscle, bone or joint problems treatment from a physiotherapist could be exactly what you need to get back to full mobility. Medicare will only cover the physio costs you incur as an inpatient in a public hospital.

This is where private health insurance comes in. When you take out an extras cover policy you can receive benefits that pay towards some or all of the cost of out-of-hospital physio treatment. Plans start from just $3 per week.

Compare extras only cover from 30+ funds

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

Which health funds in Australia cover physiotherapy?

Below are a few of the finder.com.au panel that cover pysiotherapy sessions in extras. We've displayed the yearly limit. They also include other benefits such as dental, optical or chiro - using the range of extras covered is a great way to get value for money.

Provider	Limit and Waiting Period	Additional inclusions	Cost per month	Apply
HCF Bronze	$150 2 Months	General Dental	$11.67	Go to site
HCF Silver	$350 2 Months	General Dental	$28.75	Go to site
ahm Black 50	$300 2 Months	General Dental	$13.05	Go to site
ahm Super	$600 No Waiting Period	General Dental	$80.14	Go to site

*Price based on a single living in NSW, always check for combined limits

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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