Is remedial massage covered by health insurance?
Remedial massage can be exceptionally helpful for people that suffer from pain due to an injury or general wear-and-tear. In Australia, it's recognised as a viable treatment and can be included in extras cover.
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What is remedial massage?
Remedial massage is not the same as a massage performed for relaxation; remedial massage is a type of physiotherapy and a treatment for specific ailments. It can help if you have muscle tension or chronic joint pain. By manipulating and applying pressure to specific muscles and parts of the body, remedial massage can treat carpal tunnel syndrome, back injuries and even headaches.
What costs will your health fund cover?
Private health insurers will pay a percentage of your remedial massage costs. Additional costs, such as the cost of purchasing medication, may not be included in your cover.
Remedial massage cover limits are sometimes combined with the maximum benefit for other complementary therapies such as acupuncture.
Your insurer will only pay a benefit if you use the services of a recognised practitioner. Practitioners are recognised by insurers if they’ve completed a diploma in remedial massage.
What’s involved in remedial massage?
Once you’ve selected a recognised therapist, you will need an initial assessment. An initial assessment details your medical history as well as the reason(s) for the massage therapy so that the masseuse can tailor the treatment for your circumstances.
Is remedial massage covered by Medicare, private health insurance or both?
Medicare does not provide cover for remedial massage, but you can claim the cost of remedial massage on a private health insurance extras policy. Remedial massage is a common inclusion in natural or alternative therapy cover. Remedial massage is also a worker’s compensation benefit.
Private insurers may refund you a percentage of the cost of your treatment or they may have a flat fee rebate structure in place.
Who can benefit from cover for remedial massage?
Remedial massage can help relieve muscle and joint pain and soreness. It can help if you’ve suffered an injury, for example from sports, work or a car accident, or if you have an ongoing physical ailment such as back problems. Remedial massage can even help you deal with the discomfort of pregnancy.
The following are just some of the common conditions and injuries that remedial massage therapy can help you with:
- Arthritis
- Back pain and injuries
- Whiplash
- Shin splints
- Repetitive strain injury and carpal tunnel syndrome
- Muscle cramps
- Sporting injuries
- Dancing injuries
You don’t need to be a millionaire to get private cover for ancillary treatments. Insurers include remedial massage in extras policies for under $10 a week.
Which private health insurers cover remedial massage?
You can find remedial massage limits under the Natural Therapies section of your extra cover. Some limits are combined with other natural therapies (such as acupuncture), occasionally they can be found combined with other treatments including Physiotherapy. The following table shows some picks from insurers on the finder.com.au panel who offer remedial massage, and includes an example of some of the extras cover available.
| Provider | Policy | Limit per person* | Cost per month | Wait period | Apply for cover |
|---|---|---|---|---|---|
| ahm | Black 60 Lifestyle | $200.00 $400* | $32.41 $49.86 | 2 months 0 | Go to site |
| hcf | Bronze extras Gold extras | $150* $250* | $11.67 $54.97 | 2 months 2 months | Go to site |
| transport health | Single top extras | $600* | $67.01 | 2 months | Go to site |
| nib | Core and Wellbeing | $300* | $51.08 | 2 months | More info |
| health.com.au | Extras 50 | $400* | $52.59 | 2 months | More info |
| Australian unity | Basic | $150 | $55.12 | 2 months | More info |
*Combined Limit with other natural therapies
Based on Single Female living in NSW
How do I claim remedial massage on my health insurance?
You may need to attend a practice within your insurer’s approved network of remedial massage therapists to get your rebate. Therapists who are members of an insurer's network should be able to assist with on-the-spot claims.
On-the-spot claims
You can make an on the spot claim with your insurer by swiping your private health insurance membership card in the therapist's HICAPS machine. When you make an on-the-spot claim, you only need to pay the gap. This is the difference between the cost of the remedial massage treatment and what the insurer will pay for the service.
If you’re unable to make an on-the-spot claim, you can get a refund by making a claim with the insurer directly. This can usually be completed online.
Features to look for in a health insurance policy
These policy terms and conditions are common among insurers and may impact your ability to make a claim on remedial massage therapy:
- Treatment purpose. You cannot claim for remedial massage therapy if you’re not attending the appointment for a specific reason.
- Treatment frequency. If you plan on attending multiple remedial massage sessions in the one day from the same practitioner, you can only claim once.
- One claim. If you can claim a rebate from multiple sources, for example from your private health insurance and work cover, you can only claim from one source.
- Preferred providers. In all cases, you must seek treatment from a recognised remedial massage therapist. You may be able to choose your own therapist from outside your insurer’s practitioner network.
- Waiting periods. For natural therapies such as remedial massage or acupuncture, you need to wait a minimum of two months after you’ve taken out cover before you can make a claim. If you have a pre-existing medical condition, the waiting period can be as long as 12 months.
- Qualifications. Insurers will not recognise a remedial massage therapist if they have received their qualifications online or by distance education.
What happens to loyalty limits when I change health funds?
If you change health funds, any loyalty bonuses you have accrued will not be transferred to the new fund. However, if you do change funds, any premiums you’ve paid will be considered when working out your new benefits.
You can get cover from the time you join a new fund (with no waiting periods) if you’re taking out a policy that offers the same benefits as your previous fund and you join within two months of leaving that fund.
You can compare private health insurance policies that offer extras cover (and hospital cover) using convenient online comparison websites such as finder.com.au.
