Key takeaways
- In general, podiatry services are not covered by Medicare. But some services can be accessed under enhanced primary care plans, such as for chronic conditions like osteoarthritis.
- A number of private health policies will help with the cost of in-hospital podiatric services, including accommodation and some prostheses costs. Cheaper policies include some bronze plus and silver plans.
- For general podiatry, an extras policy can cover you for around $60 a month.
Compare podiatry health insurance policies
Below you'll find a selection of policies from Finder partners that include podiatry. Each comes with a 2-month waiting period, and different conditions for orthotics. All prices are based on a single individual with less than $105,000 income and living in Sydney.
Finder survey: What extras are the most important to Australians?
| Response | Male | Female |
|---|---|---|
| Podiatry | 4.17% | 2.49% |
Finder Score - Health Insurance Extras
Each month we analyse over 10,000 extras insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare extras cover a bit faster.
We want to compare apples to apples, not apples to apple pie. It doesn't make sense to compare a top extras policy with coverage for hearing aids and braces against a policy designed only for dental. So we've separated all the extras policies on the market into pools and categories. Once in their pools and categories, each product gets a price score and a features score, which are then combined to give the Final Score.
What is podiatry surgery?
Podiatry surgery involves the surgical treatment of conditions and issues affecting the foot and ankle in hospital. Surgeries are wide-ranging and some are more complex than others. Podiatrists perform surgery on bone, joint, ligament, tendon and muscle problems of the foot or ankle.
What are my options for meeting the cost of podiatry treatment?
Podiatric surgery is performed in private practice, community health centres, day surgery centres and some private and public hospitals within Australia. To find adequate cover from a health fund, look for:
- Combined Cover. Broadly, private Health Funds may cover you for around half the cost of your treatment expense. But you’ll need Hospital and General Treatment (Extras) cover.
Your fund offers rebates for aspects of surgical services provided by podiatrists aligned to the Australasian College of Podiatric Surgeons (ACPS). These rebates cover theatre fees, bed stays in private hospitals and the costs of implantable prostheses such as pins, screws and plates.
Medicare vs Private Health insurance
Professional fees of medical practitioners undertaking foot surgeries are rebated under the Medicare system, but they aren’t applicable to podiatric surgery. Medicare will pay a percentage of your podiatry fees if you have a referral from your GP and have been put on an Enhanced Primary Care (EPC) Plan.
However, to be eligible you typically have to fall into one of the following categories:
- You are a chronically ill patient.
- You have diabetes or suffer from vascular disease.
Medicare rebates may apply only to a consultation fee in some cases; any additional services incur an out-of-pocket expense. That's why many people opt for private health insurance - which can help with things like footwear modifications and orthotics - to help them manage the overall cost of their treatments.
"Podiatry issues can start very suddenly and cause a lot of pain and disruption to everyday life. Two of my children very suddenly developed issues related to having a growth spurt, which required the treatment of a podiatrist that would have been very cost prohibitive without extras cover. "
What does podiatry surgery involve?
Surgery often involves going under general anaesthesia. While many are performed as day case surgeries, overnight stay is sometimes necessary.
Podiatrists may perform surgery for a variety of reasons, including:
- Structural deformities such as bunions, hammertoes, flat foot or high arched foot.
- Bone spurs
- Heel pain
- Nerve and tendon problems
- Nail conditions
- Trauma related injuries, such as fractures and breaks.
How long is the recovery time for Podiatry Surgery?
In general, you can expect to spend around 6-8 weeks in a cast or special post-op shoe after surgery. However, recovery time varies massively. A simple ingrown toe procedure can have you back to normal in a couple of weeks.
For more complicated procedures, such as rearfoot surgery, you may be required to keep pressure off the foot for as long as two months. Recovery can take around 6 months, with intense physical therapy sometimes necessary. Depending on the severity of your condition then, depends on the level of cover you will need.
How is podiatry covered outside of the hospital?
While podiatric surgery can be covered under a hospital policy, podiatry care can be covered in a comprehensive extras plan.
Cover can be found on mid-range or top-level extras policies, which pay a rebate on podiatry appointments outside of the hospital.
For anyone with diabetes or elderly individuals, it's really important you take care of your feet. It could even prevent you from needing surgery in the long run. That's why it can be important to have both podiatry and podiatry surgery cover.
Frequently asked questions
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Standard waiting periods apply for extras cover including podiatry. Generally you will face a two month waiting period for general podiatry consultations and treatments. For pre-existing conditions or specific items like custom orthotics, longer waiting periods of 12 months may apply. It is always best to check with your chosen health fund for exact details.
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Many extras policies that include podiatry will offer benefits for custom orthotics and some types of special footwear. The level of cover and the annual limits will vary significantly between health funds and policies. You may need a higher level of extras cover to receive a substantial rebate for these items. Always confirm with your health fund before purchasing.
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Generally you do not need a GP referral to see a podiatrist and claim benefits through your private health insurance extras cover. You can usually book an appointment directly with a podiatrist. However if you are trying to access a Medicare rebate under an Enhanced Primary Care EPC plan, you will require a GP referral. It is always a good idea to check with your health fund or the podiatrist's clinic beforehand.
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Yes, most private health insurance extras policies will have annual limits on how much you can claim for podiatry services. These limits can vary widely depending on your policy and health fund. Some policies may have combined limits for multiple ancillary services while others have specific limits for podiatry. Once you reach this limit you will pay the full cost of any further treatments until your benefits reset for the next year.
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While you generally have the freedom to choose any recognised podiatrist, many health funds have "preferred provider" networks. If you see a podiatrist within your fund's network you may receive a higher rebate or pay a lower out of pocket cost. However you can still claim benefits for services from non-preferred providers though the rebate might be lower. It is best to check with your health fund about their preferred provider arrangements.
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Finder writers are subject matter experts and use primary sources, in-depth research and interviews with other experts to ensure you're getting accurate, up-to-date information. Articles are fact checked in line with our editorial guidelines.
James Martin was the insurance editor at Finder. He has written on a range of insurance and finance topics for over 7 years. James often shares his insurance expertise as a media spokesperson and has appeared on Prime 7 News, Insurance News, 7NEWS and The Guardian. An experienced journalist, James' work has featured in publications including The Irish Times, Companies100 and In Business. He holds a Tier 1 General Insurance (General Advice) certification and a Tier 1 Generic Knowledge certification, both of which meet the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
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