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If your health is being affected by a condition that physiotherapy can treat, private health insurance can help pay for the costs – up to the limit of your cover.

In fact, this type of treatment is so popular that from 2018-19, Australians utilised nearly twelve million physiotherapy services on private health insurance over twelve months, according to the Australian Prudential Regulation Authority (APRA).1

So, let’s find out how health insurance can cover physiotherapy.

Does health insurance cover physiotherapy?

Yes, an extras policy (which covers some out-of-hospital services) can cover physiotherapy costs up to the limits of your policy. Depending on your level of cover, a hospital policy can also cover physiotherapy costs (up to the limits of your policy) that incur while you’re admitted as an inpatient.

Keep in mind that you’ll typically need to sit through a waiting period before you can claim physiotherapy on health insurance. Be sure to read through your policy brochure to get an understanding of what is and isn’t covered and whether any limits apply.

man-working-with-physiotherapist

Why get covered for physiotherapy treatment?

Physiotherapy may involve multiple visits to the specialist. As a result, the costs can add up over time. Physiotherapy cover could help pay for regular physio treatments up to the limits of your policy.

Money aside, physiotherapy could do wonders for your quality of life.

According to the Australian Physiotherapy Association (APA),2 physiotherapists have unique skills and clinical expertise to evaluate and educate people with chronic pain. With these skills, physios can guide patients through a supervised exercise program to help improve function and quality of life.

Being able to alleviate pain and discomfort can be enormously valuable to many Aussies, making these treatments tremendously appealing.

What physiotherapy services does health insurance cover?

Your extras health insurance can cover the cost (up to the limits of your policy) of initial physiotherapy consultations, follow-up consultations, treatment plans and rehabilitation.

Some extras policies will also cover other physiotherapy treatments and products, like:

  • antenatal therapies for pregnant women
  • compression-wear
  • dry needling
  • electrotherapy
  • group classes
  • hydrotherapy.

However, most health insurers typically only cover physiotherapy performed by an accredited physiotherapist or a recognised extras provider. As such, make sure you visit a physiotherapist that your insurance will cover.

Frequently asked questions

How long will I wait before I can claim physiotherapy treatments on my health insurance?

The length of time you’ll have to wait to claim physiotherapy treatments depends on your health insurer and policy, as each insurer sets its own waiting periods for extras cover. However, with health insurance, physiotherapy typically has a two-month waiting period before you can claim benefits on your cover.3

Some insurers may have longer waiting periods, while others may have promotions that waive two-month waiting periods for extras. If you’ve already sat through your waiting period, you don’t have to do so again when switching policies; provided you maintain the same level of cover.

As for how many physio sessions you can claim in one year, the amount will vary from product to product. If you want to learn more, you should start shopping around. Our comparison service can help you choose a fantastic value product for your situation, so start comparing health insurance today!

How much can I claim on physiotherapy, and are there limits?

How much you can claim on your health insurance for physiotherapy services depends on what your policy covers. Some cover a percentage of your treatment costs (e.g. 50%-60%), while others cover up to a dollar amount for each initial visit (e.g. $25-$40) or subsequent visit (e.g. $22-$35).

With health insurance, physiotherapy may only be covered up to an annual sub-limit, which is the maximum amount you can claim for physio each year.

For example, your policy’s total annual limit could be $1,200, but your physiotherapy sub-limit may be capped at $300. This sub-limit means you can’t claim more than $300 on physiotherapy services throughout the year.

Physiotherapy cover may also be subject to a group limit, which is when services are grouped together, and you have a limit to use on any of them.

For example, say your policy groups together physiotherapy, chiropractic and acupuncture with a $500 group limit. If you spend all $500 on chiropractic, you’ll reach your group limit and won’t have any money left to claim on physiotherapy or acupuncture services.

Make sure you compare policy cover limits if you’re looking for the best health insurance for physio cover and rebates.

Who might consider getting physiotherapy cover?

You might consider purchasing health insurance if you need to visit the physiotherapist regularly. Physiotherapy cover could help pay for regular physio treatments, which you may need if you:

  • have a movement disorder or neurological disorder
  • are recovering from an accident or injury
  • suffer postural or muscle pain
  • are an athlete or play sport (read more about health insurance for sports injuries)
  • work in a physical job or have an active lifestyle.

For example, let’s say you have some persistent tightness in your calf muscle after work each day. It’s not a medical emergency, but a quick consultation with a physio may provide a simple solution.

However, if the pain persists, you may have to have follow-up sessions which you’ll have to pay for out of your pocket if you don’t have health insurance cover with physiotherapy.

How much does physiotherapy cost?

The cost of physiotherapy depends on the type of treatment you receive, which clinic you visit, and what your physiotherapist charges.

We had a look at allied health pricing, provided by government department Comcare, to give you a rough understanding of what physiotherapy might cost in each state per consultation, taking into account the nature of the treatment and experience of the physiotherapist.

Make note that this is only a guide; the cost of your physio may be more or less than the prices outlined below.

Physio treatment/serviceACT NSW NTQLDSATASVICWA
Initial consultation and treatment*$96 – $145$125 – $188$121 – $151$89 – $132$85$96 – $145$119$89
Standard consultation and treatment*$82 – $122$83 – $126$62 – $78$78$78$77 – $115$59$72
Complex treatment*$162$163$197$113 – $150$94$192$119$91
Source: Australian Government Comcare – Claims & Benefits, Fees, rates and reimbursements, Allied health rates. Page updated 25/11/2020.

*Price range depending on whether the physiotherapist treats one or two areas or whether a level 1 or level 2 physiotherapist performs the treatment. Rounded up to the nearest dollar.

Does health insurance cover treatment from any physiotherapist?

Health insurance generally only covers physio treatment performed by a physiotherapist that’s accredited, qualified, allied or registered through the Australian Health Practitioner Regulation Agency (AHPRA).

Furthermore, some health insurers may only help pay for physiotherapy treatment if they have an arrangement with the provider.

If this is the case, you should check that your health fund will cover your physio treatment before making an appointment.

How do I claim physiotherapy costs through health insurance?

Swipe your insurance health care card at the physiotherapy clinic you’ve visited. Otherwise, after paying for your treatment, you can submit a claim to your health insurer to reimburse some of the costs. As such, keep proof of payment handy (e.g. receipts).

Remember that you may need to pay for some costs out-of-pocket if your physio charges you more than your policy covers. These out-of-pocket expenses are also known as ‘the gap’. Make sure you check your policy brochure to be sure of how much your policy lets you claim on treatment.

However, some health insurers may impose a time limit for extras claims, so don’t wait too long before submitting your claim.

Does Medicare cover physiotherapy?

Medicare generally doesn’t cover the costs of physiotherapy treatment performed at a private clinic. However, if you’re admitted to a public hospital as an inpatient, Medicare covers physio treatment you receive in hospital.

Alternatively, suppose you have a chronic illness and a Chronic Disease Management Plan, and your GP and at least two allied health professionals recommend physiotherapy. In that case, Medicare can cover related physio treatments.

How does physiotherapy work?

Physiotherapy works by assessing your condition and treating your physical problems through body massage, joint manipulation, muscle stretches and by providing exercises for patients to perform. This treatment can also help reduce the chances of future injuries and provide advice to improve quality of life.4

Some conditions that physiotherapy can potentially help treat5 include:

  • aches
  • arthritis
  • back and knee pain
  • children with developmental delays or movement problems
  • incontinence
  • injuries
  • neurological conditions (e.g. Parkinson’s disease)
  • occupational health (i.e. job-related injuries)
  • recovery and rehabilitation after broken bones or surgery
  • sprains.

How to find health insurance that covers physiotherapy

If you’re ready to find health insurance with physio cover, we’re here to help!

All you need to do is fill in your details and preferences, and our health insurance comparison service will provide you with options in seconds.

You can then compare these options side-by-side, potentially helping you find an extras policy that includes great-value coverage for physiotherapy.

Sources

  1. Australian Prudential Regulation Authority (APRA) – Quarterly Private Health Insurance Statistics: December 2018; March 2019; June 2019; September 2019.
  2. Australian Physiotherapy Association – Physio-led exercise best for chronic pain management. (Media release – 3 September, 2019)
  3. Commonwealth Ombudsman (Private Health Insurance Ombudsman) – Waiting periods for private health insurance. (Flyer – accessed 22 January, 2019)
  4. HealthDirect – Physiotherapy: What is physiotherapy?; What does a physiotherapist do? (last reviewed March 2018)
  5. HealthDirect – Physiotherapy: How can physiotherapy help me? (last reviewed March 2018)

So, what are you waiting for?

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