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Physiotherapy and Rehabilitation: Will Your Health Insurance Cover It?

Sally Aquire March 5th, 2012 0 comments
Health insurance extras

Physiotherapy can be used for muscle, bone and joint problems and can treat many health complaints. These include back pain, arthritis, sports injuries, asthma, emphysema, chronic bronchitis, stroke, spinal cord injuries and multiple sclerosis. Medicare generally doesn’t cover this so you will need to compare private health insurance.

If you have been badly affected by injury or illness, rehabilitation can ease you back into normal life or teach new skills. It is often done after work injuries, chronic muscle and joint issues, amputations, stroke, Parkinson’s disease, multiple sclerosis, spinal cord injury and brain injury. It can include physio but may involve other health care services.

Image by UC Physiotherapy

Physiotherapy and Medicare

Medicare generally does not cover physiotherapy services but a chronic health condition may make you eligible for some support.

Better Start for Children with Disabilities

This program may cover your child’s treatment if they have been diagnosed with one or more eligible disabilities. These include cerebral palsy, Down’s syndrome, fragile X syndrome and autism.

Each eligible disability has an eligibility threshold, and this is set out by the Department of Social Services. If your child is eligible, they must be registered before they are 6 years old, and will then have access to the programme benefits from the age of 7.

Helping Children with Autism

If your child is autistic, Medicare benefits pay for allied health services such as physio. A treatment plan must be drawn up before they turn 13, but treatment via Medicare can carry on until the age of 15. Up to 20 early intervention treatment services can be given in their lifetime.

Chronic Disease Management Programme

The CDM program allows the chronically ill to get allied health care. You must have a medical condition that has lasted for six months or more and that requires complex care from a healthcare team. This team must include two or more allied health professionals, plus your GP.

Chronic conditions can include asthma, diabetes, cancer, stroke, muscoskeletal conditions, cardiovascular diseases and arthritis. Your GP provides treatment, along with the two or more health care providers involved in your care. You can get up to five services through the CDM per calendar year.

Think you qualify for any of these? Speak to your GP. They can draw up a care plan if they feel that you would benefit.

Physiotherapy and Private Health Insurance

If you can’t use Medicare to cover your physio costs, don’t despair. Private health insurance can also help. Look for private health cover with the Extras benefits you need to cover your treatment.

The amounts that you can claim from a private health fund for these types of treatments may vary, and the cheapest health insurance may not offer the best cover. Some policies may not cover physiotherapy, or only offer basic cover.  Try to balance the cover you need against the budget you can afford for your health care costs, with or without private health insurance.

Always compare private health funds and policies before choosing the one you feel best fits your needs. You will typically need to serve a waiting period of at least 2 months with your health fund before you can claim cover for physiotherapy.

Rehabilitation and Private Health Insurance

Hospital cover can deal with in-patient treatment but this may not be enough, depending on the course of treatment and care planned out for you. You may make frequent outpatient visits for check-ups, consultations or counselling. Extras cover such as physio or mental health may help you to pay for this.

You may be treated by more than one professional, all of whom may charge different fees. Not all policies will cover rehabilitation, and many either restrict it or exclude it from cover. Compare health funds to choose a policy with enough cover for your needs. Expect to wait two months before you can claim on your private health insurance for rehabilitation.

It’s vital to compare health insurance for these Extras, as they will not always be included as standard. Medicare can potentially cover some costs for chronic problems, but you may need to use private health insurance to cover further costs.

Disclaimer: The above information is correct and current at the time of publication.

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