Physio Insurance | What is included with physio cover health insurance?

Publish date: 2024-06-14

Getting older might be unavoidable but there is something we can do about the aches and pains we blame on the passing years.

“When we get injured or sore – too many of us are too quick to put it down to ageing. It’s not,” says physiotherapist Tim Dettman.

“It’s because we’re not strong enough and we’re not active enough. Fifty five per cent of Australians are physically inactive and 90 per cent of them don’t do enough strength training.

“The right physio will guide you into a strength training plan for your muscles – and strong muscles will slow the ageing process.”

Is physiotherapy covered by Medicare?

In most cases, Medicare doesn’t cover out-of-hospital physiotherapy. However, Medicare should cover public hospital admittance for patients who need in-house treatment or rehabilitation. You’re also covered for five sessions related to chronic health conditions.

Is physiotherapy covered by private health insurance?

Physiotherapy can be covered through private health insurance extras cover, although the amount you can claim on these visits will depend on your policy’s limit. Be sure to review your policy to check what is covered and whether any limits apply.

Compare private health insurance

What is physiotherapy?

Physiotherapy is treatment to restore, maintain, and make the most of a patient’s mobility, function and wellbeing. It aims to help people move more freely and with less pain by using physical methods such as massage and exercise rather than drugs or surgery.

Constant use and strengthening may help slow down the process of muscle and bone deterioration, and improve healing in case of any injuries or diseases.

“Our strength peaks at age 30, after which we lose about 5 per cent of our strength per decade,” explains Mr Dettman.

“This increases rapidly after the age of 60, when we lose about 1 per cent per year; so the answer is the earlier the better. Every Australian over the age of 30 should do strength training twice per week, after the age of 50 it should be mandatory.”

What is physiotherapy cover?

Physiotherapy cover is an extras inclusion under some health insurance policies in Australia that can provide benefits when you see a physiotherapist.

Taking out a reliable health insurance extras policy to cover your physio needs could be worth considering if you are prone to or likely to suffer from any of the following:

– Movement disorders

– Recovery following an accident or injury

– Certain chronic illnesses

– Neurological disorders

– Back and neck pain

– Sports injuries

Compare extras insurance

What’s included under physio cover?

What and how much you’re covered for will depend on your insurer and what level of cover you have. A basic policy may have very limited coverage available, while more expensive policies will typically have more extensive cover.

For example, if you have a health insurance extras policy with physiotherapy cover you may be able to claim for some or all of the following physio services:

– An initial consultation and health diagnosis

– Follow up consultations

– The development of treatment plans

– Rehabilitation

– Dry needling

Can I claim on physio cover?

Depending on the type of extras policy you have with a physiotherapy inclusion, you will typically be eligible for one of the following types of cover:

Percentage benefits: under this benefit structure your rebate will take the form of a percentage (e.g. 50 per cent) of the fee you’re charged for eligible claims

Set benefits: rebates come in a fixed dollar amount for each claim, such as $45.

Are there waiting periods for physiotherapy?

Waiting periods – the amount of time you need to wait after taking out a policy before making a claim – are set by health insurers, not the government. Because of this, waiting periods will vary between insurers. According to the Private Health Insurance Ombudsman, the average waiting period for physiotherapy is about two months.

How often do I need to see a physiotherapist?

According to Mr Dettman, with the right physiotherapist, you won’t need to attend appointment too regularly.

“You don’t need to see a physio every week – you need to see a good physio who is going to set you up with a safe, scientific and appropriate program for you and review it periodically, every 12 weeks minimum,” he states.

“Getting the right advice is much cheaper than getting injured – I see too many people who get injured and are on the verge of giving up, don’t give up, a physio can help.”

What are the benefits of physiotherapy?

As well as shaving years off you by increasing mobility and strength, physiotherapy and strength training have wide-ranging benefits and can even make you live longer.

“Not only do stronger people have a lower risk or mortality from any cause, including stroke, cardiovascular disease and some cancers, strength training can also decrease your risk of osteoporosis (weak bones) and diabetes,” says Mr Dettman.

“And as a bonus, strength training can improve your learning and memory – by slowing the shrinking of your hippocampus- 2 vital skills that are often lost with ageing.”

FAQs: Private Health Insurance Extras

How long do I have to wait before I can claim for physiotherapy on health insurance?

If you have a new extras policy or recently upgraded your policy, you may have to serve a waiting period before you can claim for physiotherapy care. Physiotherapy generally has a two-month waiting period, but this can be longer or shorter depending on your policy.

Does physiotherapy have annual claim limits?

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

Is physiotherapy covered by Medicare?

In most cases, Medicare doesn’t cover out-of-hospital physiotherapy. However, Medicare should cover public hospital admittance for patients who need in-house treatment or rehabilitation. You’re also covered for five sessions related to chronic health conditions.

Private health insurance extras policies can also cover a range of treatments and therapies including traditional Chinese medicine, acupuncture and chiropractic.

RELATED: Thrifty dad of seven slashes $2400 off bill

RELATED: ‘Netflix for solar’ promises big savings

RELATED: Postcode lottery of household bills revealed

Originally published as Physio Insurance | What is included with physio cover health insurance?

ncG1vNJzZmivp6x7r7HWrGWcp51jrrZ7wqGcnKOfqsFwuMifnGiln6OyunvPobCsoZ%2Beu7TB0ZqlnJ1fo7K4v4ysq6iqqWSAdICSaZ1qa2GasXiFxJ2dcG9kmIF0r8WfmW1tZpivdw%3D%3D