Health insurance for physiotherapy

Compare health insurance with physiotherapy

Finder Score - Health Insurance Extras

Each month we analyse over 10,000 extras insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare extras cover a bit faster.

We want to compare apples to apples, not apples to apple pie. It doesn't make sense to compare a top extras policy with coverage for hearing aids and braces against a policy designed only for dental. So we've separated all the extras policies on the market into pools and categories. Once in their pools and categories, each product gets a price score and a features score, which are then combined to give the Final Score.

Read the full Finder Score methodology

How much is physiotherapy without insurance?

Physiotherapists will typically charge you per appointment, depending on the appointment type. Some treatments will require only a single appointment, but you'll generally need to visit a physio on multiple occasions for most issues. The table below lists some common appointment types and typical costs from Australian physios.

Appointment type	Typical cost
Initial consultation	$50-$200
Standard appointment	$100-$125

What amount will I be able to claim back?

Depending on the health fund and extras policy you choose, your benefit amount for physio services may be calculated in the following ways.

• Set benefit. This means that your rebate will take the form of a fixed dollar amount for claims on eligible services, such as $40 or $50.
• Percentage benefit. Alternatively, your rebate may be calculated as a percentage of the total fee charged for the service, for example 50% or 75%.

It is also worth remembering that an annual limit will apply to the maximum rebate you are able to claim per person. Luckily, your extras benefits reset each year.

What physiotherapy expenses are covered?

Health funds cover physio on extras policies, although the benefit amounts provided will depend on the level of cover you choose. For example, a basic extras policy may only provide limited benefits or even exclude physio altogether. However, if included an extras policy will generally cover the physio-related services listed below.

Be aware that there are certain physio-related items that are not commonly covered by private health funds. These can include foam rollers, trigger balls and sports tape. Also keep in mind that services and items that can be claimed may differ between health funds and individual extras cover, so make sure to compare the features of each policy closely before making a purchase.

Does Medicare cover any physiotherapy services?

For most out-of-hospital physiotherapy, Medicare does not provide cover, so you'll need to cover the cost either out-of-pocket or with private health insurance. However, there are 2 situations where Medicare can provide benefits for physio-related treatment - during public hospital admittance, and for chronic disease management:

• Public hospital admittance. Medicare provides some benefits for public hospital patients who need inpatient physio treatment or rehabilitation.
• Chronic Disease Management program (CDM). Medicare may also cover certain physio-related services if they are part of a CDM recommended by at least two allied health professionals and a GP. Eligible chronic diseases can include arthritis, diabetes, cancer, stroke and musculoskeletal conditions.

Frequently asked questions

• What health insurance will cover physiotherapy?

  To cover physiotherapy you'll need extras health insurance. You can get an extras policy that covers physio from as little as around $4 per week. More expensive policies will generally offer a larger benefit for each visit and a larger annual limit.

• How much is physiotherapy without insurance?

  The cost of physiotherapy without insurance varies depending on the type of appointment, but expect to pay between $90 and $150 for a typical visit.

• Can I get physiotherapy cover with no waiting period?

  Yes, there are extras policies with no waiting period for physiotherapy. Some extras policies such as ahm lifestyle and super extras, already have no waiting periods for a range of services including physio. You can also have the normal 2-month waiting period waived with many health insurance sign-up deals.

• Does Medicare cover physio?

  Medicare only covers physiotherapy during a public hospital visit, or to manage chronic disease management. For most out-of-hospital physiotherapy services, such as sports physio, Medicare does not provide a benefit.

• Is physiotherapy cheaper for pensioners?

  Pensioners may be able to get cheaper services from some clinics - eg Total Physiotherapy charges just $85 for both initial and subsequent consultations to pension card holders.

• Who can benefit from physio cover?

  No matter how active you are or what life stage you are at, there are plenty of reasons why you might be able to benefit from private health insurance cover for physiotherapy:

  • If you have developed a movement disorder of any kind.
  • If you are restricted by a chronic illness.
  • If you are recovering from an injury.
  • If you play a sport with a risk of physical injury.

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• How do I lodge a claim with my health fund?

  There are several ways you can claim physiotherapy on your health insurance, but keep in mind that your health fund may not offer all of the following claim options.

  • On the spot. Use your membership card to submit your claim electronically through HICAPS when you visit your physio.
  • Online. Use your health fund's online claims service to submit the details of your claim, including a receipt from your physio.
  • Via an app. Many health funds offer claims apps that allow you to submit a photo of your receipt and claim.
  • Via email, fax or post. Fill out a claims form, attach a copy of your receipt and email, fax or post it to your health fund.
  • In person. If your fund operates bricks and mortar branch, visit one of these in person to submit your receipt and claim.

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