Explore Health Insurance

Joshua MalinWritten by Joshua Malin
Reviewed by Lana Hambilton
Last updated 18/12/2023

Key takeaways

Chiropractic healthcare is a well-known method of treating back and neck pain. But what exactly does chiropractic treatment do? And does private health insurance cover chiropractors in Australia?

We’ll take you through how chiropractic treatment works, how it’s covered, the out-of-pocket expenses you can expect and more.

  • If you suffer from chronic pain in your neck, shoulders or back or you experience frequent headaches, it might be worth talking to your GP to see if a chiropractor could help.
  • An extras health insurance policy could pay a benefit towards chiropractic services, but there are likely to be limits to how much you can claim.
  • For your health insurance to pay towards your chiro fees, your chiropractor will need to be registered and recognised by your health fund.

Why take out health insurance with chiropractic coverage?

If you’re not sure whether to take out cover for chiropractic treatment, here are a few questions to ask yourself to help make up your mind:

  • Do you work a physically demanding job that takes a toll on your body?
  • Do you play any sports or engage in any activities that pose a significant risk of an injury?
  • If you were unexpectedly injured, would you be comfortable waiting to complete your waiting periods (or paying the full cost out of pocket), or would you want to access treatment and claim a benefit right away?

If you answered yes to any of these questions, you could potentially benefit from chiropractic coverage. A chiro could help you recover from an injury or manage chronic pain, so you can focus on the things that matter.

 

Choosing cover for chiropractors

Once you’ve decided to get health insurance with chiropractic cover, the next step is to compare your options to find a policy that suits you. Everyone’s circumstances are different, but there are a few things you might like to keep in mind while you browse:

  • Waiting periods. For extras cover, waiting periods for services differ between health funds. Some funds may even waive waiting periods in certain situations.
  • Type of benefit. Some health funds will pay your benefit as a percentage of your chiro fee, while others will pay a fixed dollar amount.
  • Preferred providers. Many health funds will have preferred healthcare providers. When you’re treated by one of your health funds preferred providers, you could receive a discounted rate or higher rebate.

Executive General Manager of Health Life and Energy

Expert tips on choosing health insurance for chiropractic coverage

Our health insurance expert, Steven Spicer, has some tips for you on how to find a policy with chiropractic cover that works for you.

Know your options

If you plan on using chiropractic cover regularly, it’s worth comparing your options because limits and rebates can vary significantly between health funds. You might find a better-value policy out there that can take more financial pressure off your regular visits.

Review the group limits on your policy

Chiropractic cover is often grouped with other services. If these are services that you use regularly, you may quickly use up your group limit and find yourself paying out of pocket until your limits reset. If this is the case, you might want to look for policies with higher group limits or policies that don’t group chiropractic cover with other services that you regularly claim on.

Watch out for sub-limits

Occasionally, a sub-limit will be applied to chiropractic cover, which is the maximum that you can claim on that service within your overall extras cover. If you’re planning to use chiropractic cover regularly, check your sub-limits to make sure you have enough cover for what you need.

How chiropractic treatment works

Woman visits chiropractor for joint pain

What is chiropractic treatment?

Chiropractic therapy is a universal method used to diagnose and treat musculoskeletal issues and help alleviate pain. This type of treatment manipulates the spine, joints and the body’s alignment by adjusting the body’s position and applying pressure on trigger points by hand or instrument.

If you visit a chiropractic healthcare centre, therapy could also include physical training to fix posture and limit the strain on your back when you sit, stand or walk.

Chiropractic therapy can include a range of treatments and techniques, such as:1

  • Spinal manipulation
  • Joint movement and mobilisations
  • Stretching and exercises
  • Heat or ice application
  • Soft tissue massage.

Chiropractic therapy can potentially treat a range of health problems such as back pain (commonly lower back pain), neck pain, headaches and migraines, posture issues and sciatica (shooting pains in the leg).2

Who should consider using a chiropractor?

You might benefit from chiropractic treatment if you have regular chronic pain or limited movement in your back, neck, shoulders, muscles, joints or limbs, or have frequent headaches. If your GP recommends chiropractic, you might want to consider getting an extras health insurance policy to help pay for such services.

Conversely, you might consider getting health insurance with chiro cover if you have a higher chance of joint or back problems and injuries, such as if you:

  • Work in a physical job
  • Play regular sports
  • Had a recent car accident and suffered whiplash
  • Find daily activities and household chores put too much strain on your body

How do I know if a chiropractor is registered?

Chiropractors in Australia need to register through the Australian Health Practitioner Regulation Agency (AHPRA); you can search the AHPRA database to see if your chiropractor is registered. It may also be a good idea to read reviews of a chiropractor to see how others rated their treatment.

How much does a chiropractor cost?

In terms of how much chiropractic treatment costs, prices will differ depending on where you live, the clinic you visit and the treatment you need. However, Comcare, the national authority for workers’ compensation does provide guidance on the recommended upper limit fees for chiropractors and other allied health services. While chiros don’t have to follow these recommended rates, many will if they want to treat workers’ comp clients.

The average recommended fee across Australia for your initial consultation with a chiropractor (including an examination and evaluation) is around $95.3 Meanwhile, the average cost of a follow-up or standard consultation is around $70.

 

Chiropractic treatment and health insurance

patient visits chiro with health insurance

Does health insurance cover chiropractic visits?

Yes, chiropractic services can be included on a private health insurance extras cover policy. If your private insurance does pay a benefit towards sessions with a chiropractor, the amount you can claim on your visits will depend on your policy.

These services are typically only included on extras health insurance policies, not hospital policies, but not all health insurance plans pay a benefit towards these services. Be sure to read through your policy brochure to understand what is and isn’t covered and whether any limits apply.

How much can I claim on chiropractic through health insurance?

When you receive treatment, the amount you can claim back will vary depending on your insurance company and policy. With some extras policies, you can claim back a percentage amount (e.g. 50-60%), while others will pay a dollar amount (e.g. $25-$35) for each visit to the chiropractor.

Regardless of your benefit type, you won’t be able to claim above your extras policy limits, and there are different types of limits that can apply. Refer to your policy documents to understand your limits and how they work.

Discover how HICAPS can help you make a claim instantly when you visit your chiropractor.

Does chiropractic health insurance have annual claim limits?

Yes, extras health insurance policies will typically have annual limits on how much you can claim, which vary depending on your policy. For example, your policy may have coverage limits of $200-$700 to spend on chiropractic health care every year.

Some policies may also group particular services (e.g. physiotherapy, chiropractic, acupuncture, remedial massage) together under one benefit, and the amount you can claim for chiropractic will be subject to this ‘group limit’. For example, you may have a maximum of $500 to claim over the year on any therapies in the group.

If you’re looking for cover with adequate chiropractic care rebates, you should look for a health insurance policy that offers higher limits for chiropractic than other policies, as well as affordable premiums.

How long do I have to wait before I claim chiropractic on health insurance?

If you’re taking out a new extras policy or upgrading your current one, you may have to serve a waiting period before you can claim chiropractic on your health insurance. The waiting period for chiropractic services is generally two months, but this can vary depending on your policy.

When signing up for a new extras health insurance policy, some health funds may have promotions that waive the shorter waiting periods (such as two and six months), allowing you to claim immediately.

Is chiropractic health insurance subject to any other conditions?

Your health fund may outline particular requirements that you need to meet to claim for chiropractic services. For example, health funds may have a condition that you can only claim chiropractic sessions if your treatment is carried out by an approved chiropractor that is recognised by the health fund.

Your policy brochure will contain more information about such conditions or requirements, so make sure you read this before you sign up to know what you’re covered for.

 

Is chiro covered by Medicare?

Generally speaking, Medicare doesn’t usually cover chiropractic under the Medicare Benefits Schedule (MBS). However, if you’ve had a terminal or chronic condition for six months or longer, you may be eligible for a GP Management Plan and Team Care Arrangements (TCA).4

With this care plan, you’ll have access to Chronic Disease Management (CDM) items under Medicare. Upon referral, you’ll be eligible to receive Medicare rebates for five individual visits to an allied health professional (e.g. chiropractor) per calendar year. If you aren’t eligible for this care plan, you can still go to a chiropractor without health insurance, but you’ll have to pay the full out-of-pocket costs.

Medicare can also help pay for examinations like X-rays, which you can use in conjunction with chiropractic services.


Executive General Manager of Health Life and Energy

Meet our health insurance expert, Steven Spicer

As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.

Steven has 20 years of experience as a people-first business leader, with a focus on creating services that put customers first.


Sources

1 Victoria State Government – BetterHealth Channel: Chiropractic, Chiropractic treatments. Accessed March 2023.
2 Healthdirect – Chiropractors: what conditions do chiropractors treat? Accessed March 2023.
3 Comcare – Rates for medical and allied health treatment. Averaged across Australia for comparable services. March 2023.
4 Australian Government Department of Health – Chronic Disease Management: Provider Information. Accessed March 2023.

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