Written by Joshua Malin
Reviewed by Lana Hambilton
Last updated 14/11/2023
Extras health insurance can include a range of outpatient health services that Medicare doesn’t pay towards (sometimes called ancillary services). This includes natural therapies like remedial massage and alternative medicines, which have grown in popularity over the years.
Here are a few things to keep in mind if you’re considering a policy that includes natural therapies and massage:
- Health funds and policies can differ when it comes to the type of natural therapies that they may choose to pay a benefit towards. However, there are a few common inclusions you’ll see.
- There’s a range of natural therapies that private health funds are legally not allowed to contribute towards due to a lack of evidence of their efficacy.
- Even if you have an extras policy that includes natural therapies, there are likely to be some out-of-pocket costs which may vary between health funds and policies depending on their claim limits.
Why take out cover for massage and natural therapies?
Whether or not you need cover for massage and natural therapies ultimately depends on your own health needs and budget. However, there are a few things to think about if you’re considering cover:
- The reason for the treatment. Remedial massage is specifically designed to treat various health conditions. If you’re just looking for a massage to help with stress relief, another type of massage might be more suitable.
- How often you need treatment. You can only claim one treatment per day, and all extras covered by your policy are typically subject to annual limits. So, if you have an annual limit of $500 for massage therapies, that’s how much you can claim during the year.
- Therapists’ qualifications. The therapist who treats you will have to be suitably qualified for your health fund to pay out any claim you’re looking to make. So, if you have a particular provider in mind, double-check their qualifications before taking out cover.
Choosing cover for massage and natural therapy
If you think cover for massage and natural therapies would be suitable for you, all that’s left to do is compare your options to find a policy that meets your needs. Here are a few things to keep in mind while you browse:
- Group limits. Some extras policies group certain services together with a shared limit to be used between them.
- Preferred healthcare providers. Some insurers will have agreements with certain specialists known as ‘preferred providers’ with whom you may receive a higher rebate.
- Waiting periods. When you take out cover, there’s typically a waiting period before you can claim on new or upgraded services. For extras cover, this can vary between health funds so keep an eye out for a lower waiting period.
Expert tips for choosing the right massage and natural therapy cover for you
Our health insurance expert, Lana Hambilton, has some tips for finding an extras policy that offers the massage and natural therapy cover you’re looking for.
Review the group limits on your policy.
Remedial massage and natural therapies are often grouped with other services, meaning that you’re sharing one annual limit across multiple services. If these are services that you use regularly, you may find yourself using up this limit quickly and paying out of pocket until your limits reset. Policies with higher group limits or ones that don’t group your commonly-used services may suit you better.
Watch out for sub-limits.
Some policies apply sub-limits to remedial massage and natural therapies. This means that while you may have a certain amount (e.g. $1,000) to spend on extras services including massages, you may only be able to spend a portion (e.g. $300) of that on massage treatments. If you use remedial massage and natural therapies regularly, you may want to consider policies with high or even no sub-limits.
Compare your options.
Annual limits, group limits and rebates can vary significantly when it comes to remedial massage and natural therapies, so it’s a good idea to shop around to find the best option for your needs.
What massage and natural therapies does private health insurance cover?
The following are some of the most popular natural therapies in Australia that can be included on a private health insurance extras policy.
The services you can claim will vary based on your health fund and the level of extras cover you take out. Be sure to read through your policy brochure to understand what is and isn’t included and whether any limits apply.
Remedial massage is a type of physiotherapy that involves a variety of techniques designed to treat the cause and symptoms of issues that make it hard to move.1 Remedial massage treatment works alongside and can include other types of massage, such as deep tissue massage, trigger point therapy, myotherapy and sports massage. Depending on your policy and the type of therapist you see, these treatments may be included under different services, so always check with your health fund to know how you’re covered and what your rebate would be.
Each type of remedial massage therapy will have a different emphasis. However, techniques and treatment methods may overlap. Typically, these treatments involve a remedial massage therapist physically manipulating the patient’s body, muscles, and nerve points to treat a variety of symptoms, like back pain, arthritis, and muscle tension.
Acupuncture is a natural therapy originating in China that has been practised for thousands of years.2 This therapy works by using fine needles that are carefully inserted into specific points across the skin. Acupuncture is used to treat a variety of conditions, such as dental pain, jaw pain and nausea following chemotherapy or surgical operations.
During treatment, an acupuncturist may perform several techniques. These include light suction on the skin to bring blood closer to the point, burning herbs and holding them over the acupuncture point (known as moxibustion) and even the use of a laser.
The government service Healthdirect notes that while traditional Chinese medicine has had limited clinical trials, there are some proven benefits to traditional herbal medicine in treating gynaecological and gastrointestinal disorders, among others.3 However, some natural therapies originating in Chinese medicine, such as tai chi, are no longer covered by health insurance. When you claim on Chinese medicine through your health insurance, you’ll only receive a rebate for the consultation.
Private health insurance for massage and natural therapies
Which natural therapies are no longer covered by health insurance?
As part of the Australian Government’s changes to private health insurance in 2019, over a dozen natural therapies were removed from extras cover. The following 16 natural therapies are no longer covered by your private health insurance policy, regardless of whether you were covered for them previously:
- Western Herbalism
- Tai Chi
- Alexander Technique
- Bowen Therapy.
These government changes to private health insurance extras were made due to a lack of evidence for the health benefits of the listed services. However, the Australian Department of Health is currently conducting a review into the effectiveness of these treatments to assess whether they can be reinstated in private health cover.4
Out-of-pocket expenses for massage and natural therapies
The difference between what your health practitioner charges and your health fund rebate is called a gap payment or out-of-pocket expense. Depending on which service you use and how much your policy allows you to claim, there may be some out-of-pocket costs for your massage therapy treatments.
When you receive treatment for a service included on your extras policy, you may be able to scan your health fund membership card at your healthcare provider’s HICAPS machine, which will charge your health fund directly for their portion of the costs. This way, you’re only required to pay the gap. Otherwise, you may need to pay the full cost out of pocket and submit a claims form to be reimbursed at a later date.
Waiting periods and annual limits for natural therapies
A typical waiting period for natural therapy services is two months, depending on your insurer. If you switch policies, you won’t have to reserve the waiting periods you’ve already served, provided you switch to a policy with the same or a lower level of cover. If you switch to a higher level of cover, you’ll have to serve a waiting period before you can access your new services or additional cover limits. However, you can still claim on services up to your previous cover’s limit while you wait.
Aside from waiting periods, another thing to look out for is annual limits. This is the limit on the amount your health fund will pay towards treatments and services (including natural therapies) within a 12-month claiming year.
Meet our health insurance expert, Lana Hambilton
As Head of Health, Life, and Income Protection Insurance at Compare the Market, Lana Hambilton is passionate about simplifying the comparison process and educating Australians about the value and benefits private health insurance can offer and the critical role it plays in our medical system. She firmly believes that health insurance provides choice in one of the most important aspects of life – our health – and has experienced countless cases over the years where peace of mind comes through the ability to choose when, where, and who will treat you.
Lana has 15 years’ experience in the health insurance and insurance comparison industries. She’s also a Board Member of the Private Health Insurance Intermediaries Association.
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