Natural therapies and massage with private health insurance

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.

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:

• Aromatherapy
• Naturopathy
• Yoga
• Kinesiology
• Homeopathy
• Western Herbalism
• Pilates
• Tai Chi
• Reflexology
• Iridology
• Alexander Technique
• Rolfing
• Shiatsu
• Feldenkrais
• Buteyko
• 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

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.

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.