Occupational therapy helps with the development or recovery of key physical and mental abilities.
Top private health plans with extras insurance often have cover for occupational therapy services.
Expect a 2-month waiting period before you can start claiming money back. Benefit limits usually range from $200 to $500 per year.
Medicare covers occupational therapy for children and adults in Australia, but you'll need a referral and it only covers 5 sessions — the current rebate is $55.10. Fortunately, a handful of comprehensive extras insurance policies can cover you if you need more.
Compare health insurance for occupational therapy
Here's a list of the insurers that will cover you for occupational therapy. All prices are based on a single individual with less than $93,000 income and living in Sydney.
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below
You'll pay the same price as going direct - we don't
charge fees
We don't ask for your phone number to see prices
Hang tight - we're fetching policies just for you!
Comparing quotes from 30+ funds...
Using private healthcare for occupational therapy: Pros and cons
Pros
Many types of occupational therapy aren't covered by Medicare. Your private health fund may offer you access to a wider range of options and treatments.
If you've used up your available sessions through Medicare, your insurance can help with future expenses for more services.
With wide-ranging health insurance in place, you could supplement your occupational therapy benefits with related perks listed under 'health aids'. For example, cover for assisted-living devices such as wheelchairs.
Cons
Benefit limits tend to be capped at around $500. This may be okay for occasional sessions, but it'll fall short of more extensive therapy plans. If you're recovering from a traumatic injury, or you need ongoing treatment for a disabled child, you wouldn't be able to rely on this particular insurance cover.
Even with a top-draw extras policy, you may only cover between 60% and 75% of the full cost of a private session. Coupled with the aforementioned benefit limits, you may struggle to see a clear advantage with private cover, when you factor in the price of your premium each month.
Finder survey: What extras are the most important to Australians?
Response
Male
Occupational therapy
0.63%
Source: Finder survey by Pure Profile of 1006 Australians, December 2023
What type of services does occupational therapy offer?
Occupational therapy includes a range of services, including as follows:
Teaching people how to live with ongoing injuries or illnesses.
Assessments of whether a disabled person can drive safely, or can carry out certain tasks.
Teaching developmentally delayed children the everyday skills they will need in life.
Training people in the use of wheelchairs and other assisted-living devices.
Arranging employment for disabled people and following up to see if it's suitable.
Assessing the need for assisted-living devices for elderly or disabled individuals.
Which occupational therapy costs are covered by health insurance?
Private health funds
Private health funds can cover occupational therapy, but will usually require you to purchase more comprehensive extras (or ancillary) options. They will typically only cover a portion of the costs, usually 60–75%.
Before covering occupational therapy, many private health insurance brands may also require:
Referrals from doctors
Your occupational therapist to be licensed and registered with Medicare, or to similar standards
Your treatment to be carried out with the goal of treating a medically diagnosable condition
Private health funds will readily subsidise occupational therapy if the conditions are fulfilled. Beware of low limits, however: your annual occupational therapy limit might be, for example, only $450 per year. This may be enough for occasional sessions, but is too low for extensive therapy following an accident or ongoing treatment for a disabled child.
Although the actual occupational therapist session limits may be relatively low, most private health funds cover medical and assisted-living devices, such as wheelchairs, separately under health aids.
Medicare
To claim occupational therapy sessions with Medicare you typically need to have been referred to the provider by a licensed healthcare practitioner, and the occupational therapist must be a registered member of the Occupational Therapy Board of Australia.
Referrals will generally be made if:
Occupational therapy can help someone with a developmental disorder such as autism.
The practitioner believes it can help someone who has a medically diagnosable mental illness or disability.
It is for a child who has a specific disorder, such as Down syndrome, which can benefit from occupational therapy.
If occupational therapy is needed to use assisted-living devices or achieve certain outcomes, like being able to return to work or live independently with a disability.
With a valid referral, Medicare will cover 100% of the cost of a limited number of treatment sessions per year, typically about five to fifteen, depending on the condition. In some cases the outcomes achieved must be reviewed after a certain number of treatments; if the occupational therapy is achieving good results then more sessions may be approved.
Most types of occupational therapy are not covered by Medicare. Generally, only specific therapies for specific disorders or disabilities will be covered and you have very little control over the treatment offered.
How do I claim occupational therapy on my health insurance?
Medicare
To claim occupational therapy through Medicare you must:
Step 1. Acquire a referral for occupational therapy services from a practitioner registered with Medicare.
Step 2. Your therapist will report progress back to the referrer.
Step 3. The therapist will claim the expenses directly from Medicare.
Step 4. Continue attending scheduled sessions until you achieve the desired result or you reach the treatment limit. If you have reached the limit then you may be eligible for further sessions, following a review of your case.
Private health insurance
If you are lodging your occupational therapy claim through a private health fund, you'll have to:
Step 1. Visit an approved occupational therapist recognised by your health fund. If you are unsure whether a practitioner is approved you can simply ask them.
Step 2. Pay the portion of their fees that you owe. The remainder (to be covered by insurance) can be paid in varying ways depending on your health fund and might involve swiping an insurance card, sending in a claims form or simply letting your therapist work it out with the insurance company.
Step 3. Be mindful of limits. If you exceed your health fund's annual or lifetime limit for occupational therapy services, even by accident, then you are still liable for outstanding costs.
What terms should I look for in an insurance policy, when it comes to occupational therapy?
Look out for some specific terms when selecting an insurance policy.
Exclusions. These are not covered. In health insurance for occupational therapy you might encounter exclusions like:
Services outside Australia (approved occupational therapists are required to offer their services in Australia).
No cover unless there is a named purpose for the procedures. For example, you could likely get cover for occupational therapy which reteaches fine motor skills following brain injury through a sewing class, but could not for a standard sewing lesson.
Additional costs like administration fees are generally not covered.
Benefit limits. These are the maximums of your policy, or the most you can claim in a certain period of time. These benefits can be a certain number of treatment sessions or a dollar value of treatments.
Medicare has limits on the number of occupational therapy sessions per year.
Generally, because of the applicable limits and excesses, private health funds are not necessarily the best option for people who require extensive or ongoing occupational therapy and are hoping to meet a wide range of these costs through insurance. That said, it could still be worth doing a full comparison of your options with health insurance.
Why you can trust Finder's health insurance experts
You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
Frequently asked questions
Occupational therapy is a type of healthcare that helps to treat physical, mental, developmental and cognitive issues. It helps people whose health or disability makes it hard for them to perform day-to-day tasks.
Yes, but only up to 5 sessions per calendar year. Generally, you'll need to have a chronic medical condition that's been present for a minimum of 6 months. Your eligibility is decided by your doctor.
Everyone is able to benefit from the occupational therapy offered by private health funds, but usually only in a few circumstances. For the people who really need it, Medicare perhaps does a better job of making occupational therapy affordable.
Medicare. Generally, a favourable option for people looking to treat specific conditions or achieve certain outcomes through occupational therapy, as long as these conditions and outcomes are approved. The Medicare limits may still be too low to achieve all the results you want, but it will greatly reduce your costs.
Private health insurance. Generally more for people looking to cover incidental occupational therapy needs, such as wheelchair training following an accident or group therapy to learn how to live with disabilities. For treating specific issues, the cost of health fund premiums and the low limits could mean it's not generally value for money.
Gary Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
Gary Ross's expertise
Gary Ross has written 729 Finder guides across topics including:
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, WIN News, Insurance News, 7NEWS and The Guardian. 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
James's expertise
James has written 258 Finder guides across topics including:
Remedial massage can help ease pain from general wear and tear as well as specific injuries. This treatment isn’t covered by Medicare but is included in private health insurance extras cover. Find out how private health insurance can cover you for remedial massage therapy.
Physiotherapy services can be beneficial at any life stage, so it could be worth considering and comparing extras health insurance that can cover the cost of this type of treatment.
If you're wondering what pharmaceutical costs are covered by private health insurance, we've got a guide to health cover for non-PBS pharmaceuticals here.
Feedback
How likely would you be to recommend Finder to a friend or colleague?
0
1
2
3
4
5
6
7
8
9
10
Very UnlikelyExtremely Likely
Required
Thank you for your feedback.
Our goal is to create the best possible product, and your thoughts, ideas and suggestions play a major role in helping us identify opportunities to improve.
Important information about this website
finder.com.au is one of Australia's leading comparison websites. We are committed to our readers and stands by our editorial principles
We try to take an open and transparent approach and provide a broad-based comparison service. However, you should be aware that while we are an independently owned service, our comparison service does not include all providers or all products available in the market.
Some product issuers may provide products or offer services through multiple brands, associated companies or different labeling arrangements. This can make it difficult for consumers to compare alternatives or identify the companies behind the products. However, we aim to provide information to enable consumers to understand these issues.
We make money by featuring products on our site. Compensation received from the providers featured on our site can influence which products we write about as well as where and how products appear on our page, but the order or placement of these products does not influence our assessment or opinions of them, nor is it an endorsement or recommendation for them.
Products marked as 'Top Pick', 'Promoted' or 'Advertisement' are prominently displayed either as a result of a commercial advertising arrangement or to highlight a particular product, provider or feature. Finder may receive remuneration from the Provider if you click on the related link, purchase or enquire about the product. Finder's decision to show a 'promoted' product is neither a recommendation that the product is appropriate for you nor an indication that the product is the best in its category. We encourage you to use the tools and information we provide to compare your options.
Where our site links to particular products or displays 'Go to site' buttons, we may receive a commission, referral fee or payment when you click on those buttons or apply for a product. You can learn more about how we make money.
When products are grouped in a table or list, the order in which they are initially sorted may be influenced by a range of factors including price, fees and discounts; commercial partnerships; product features; and brand popularity. We provide tools so you can sort and filter these lists to highlight features that matter to you.
Please read our website terms of use and privacy policy for more information about our services and our approach to privacy.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
