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Extras health policies can cover a range of health services received out of hospital that Medicare doesn’t pay for (sometimes called ancillary services). Natural massage therapies and alternative medicines are both extras benefits that have been growing in popularity over the years.

However, not all natural therapies may be covered by private health funds. Even for government-approved treatments, whether your health fund will cover them or not is up to them and may depend on your level of cover. Let us take you through some of the most popular natural therapies and whether they qualify for health fund rebates.

What massage and natural therapies does private health insurance cover?

The following are some of the most popular natural therapies in Australia that are covered by private health insurance.

Remedial massage

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. 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 are seeing, these treatments may be covered under different services, so always check with your provider to know how you’re covered and what your rebate would be.

Each type of remedial massage 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 and arthritis.

Acupuncture

Acupuncture is a natural therapy originating in ancient China that has been practiced for thousands of years. 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.

Chinese Medicine

The government service Health Direct notes that while Chinese medicine has had limited clinical trials, there are some proven benefits to traditional herbal medicine in treating gynaecological and gastrointestinal disorders, among others.1 However, some natural therapies which have their origin in Chinese medicine, such as tai chi, are no longer covered by health insurance. When you claim on Chinese medicine you’ll only be covered for the consultation.

N.B. The services you’re able to 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 get an understanding of what is and isn’t covered and whether any limits apply.

Woman receives massage through her private health insurance

Which natural therapies are no longer covered by health insurance?

As part of the government 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 were made due to the lack of evidence of the effectiveness 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.2

Out of pocket expenses for massage and natural therapies

The difference between what your health practitioner charges and what your insurer pays for is called a gap payment or out of pocket expense.

There may be some out-of-pocket costs for your massage therapy treatments, depending on which service you use and how much your policy allows you to claim. You’ll need to check your policy brochure to be sure.

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 sit through 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 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 of money your health fund will pay towards treatments and services (including natural therapies) within 12 months.

What should I look for when claiming massage and natural therapies through private health insurance?

There are a few things you’ll need to consider when being treated with remedial massage or other natural therapies, including:

  • The reason for the treatment. To claim on remedial massage or other natural therapies, you’ll need a specific reason for treatment, such as a sporting injury, repetitive strain injury (RSI) or other ailments. If you don’t have a reason for treatment, you can’t make a claim through your extras policy.
  • How often you need treatment. You can only claim one treatment per day and all extras covered by your policy are subject to annual and lifetime limits. So, if you have an annual limit of $500 for massage therapies, that’s how much you can claim during the year.
  • If your health fund has preferred providers. Some insurers will have agreements with certain specialists known as ‘preferred providers’ with whom you may receive a higher rebate for.
  • Waiting periods to serve. Before seeking treatment, it’s important to ensure you’ve served any relevant waiting periods. Otherwise, you won’t be able to claim on massage therapies.
  • Therapists’ qualifications. The therapist you receive treatment from will have to be suitably qualified for your health fund to pay out any claim you’re looking to make.

Anthony Fleming, General Manager

Tips on massage and natural therapies from our health insurance expert Anthony Fleming

  1. Review the group limits on your policy. Remedial massage and natural therapies are often grouped with other services. This means that you are 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. If this is the case, then you may wish to look for policies with higher group limits, or policies that do not group your commonly used services together.
  2. Watch out for sub-limits. Some policies apply sub-limits to remedial massage and natural therapies. This is the maximum you can claim each year on a particular service. If you use remedial massage and natural therapies regularly, then you may wish to avoid policies with low sub limits.
  3. Compare your options. Annual limits, group limits and rebates can vary quite significantly when it comes to remedial massage and natural therapies. Therefore, it’s a good idea to shop around in order to find the best option for your needs.

Is it time to get covered?

Finding private health insurance for natural therapies can be a difficult task because each one will have different inclusions, exclusions and limits.

If you’re thinking about taking out private health insurance, you can compare and buy policies from some of Australia’s leading health funds for free using our health insurance comparison service. Choose what you want from your cover and compare results side-by-side, all in one place, within a few minutes.

Sources

1 Chinese traditional medicine. Health direct. Last reviewed February 2020

2Natural therapies review 2019-20. Health.gov.au. Last updated October 2021

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