What is health insurance with physiotherapy cover?
In Australia, physiotherapy is generally included as a part of extras cover. This type of insurance allows you to claim some of the costs of your physio sessions back, up to an annual limit. Extras can also cover you for a range of other services like dental and optical.
What is physiotherapy?
Physiotherapy is a treatment that aims to help people move freely and with less pain by using physical methods such as massage, movement and exercise. Physiotherapy can assist in the recovery and rehabilitation of certain injuries, and may assist in the treatment of:
- Back and knee pain
- Arthritis
- Muscle aches and pains
- Sprains and strains
- Limb injuries
- Occupation health
- Children with developmental delays or movement problems
- Neurological conditions
- Palliative care
- Incontinence
How does health insurance with physiotherapy work?
Most extras insurance policies in Australia include cover for physiotherapy as a standard inclusion. Once you’ve served the relevant waiting periods, you’ll be able to claim back part of the cost of your physio treatments. The amount you can claim for each session will depend on your provider and policy.
Extras cover typically comes with an annual limit, which is the total amount you can claim in a calendar year. Some providers will give you a percentage back for each physiotherapy session—for example, 60% of the cost of each visit—until you hit your annual limit. Some may instead offer a certain amount (i.e. $500 annually for physio treatments).
Some health insurance providers will have a network of preferred or partner providers—these are physiotherapists who have an arrangement with your health fund. If you choose to be treated by these providers, you may be able to claim a higher percentage back than you would at other physiotherapists, potentially even up to 100% of the cost.
Consult the policy’s Private Health Information Statement (PHIS) or contact the provider directly for more information.
How much does physiotherapy cost?
The cost of your physio sessions will ultimately depend on your choice of physiotherapist, as well as the details of your extras policy. The Australian Physiotherapy Association (APA) suggests that an appropriate hourly rate for physiotherapy services in Australia is $261, or $130.50 for a 30 minute session. This hourly rate can increase depending on a physiotherapists’ experience and qualifications, with the APA suggesting:
- Physiotherapists with extensive experience: $300
- APA titling or equivalent qualification: $313
- APA specialisation: $365
- Compensable schemes in rural and remote locations: $313 (additional operation costs may apply depending on the location).
Why take out cover for physiotherapy?
- Physiotherapy can help treat a wide range of conditions and ailments
- It may help with your recovery after an elective surgery
- Preventative physio services can help you avoid injuries long term
- If you already regularly visit the physio, you may be able to save on costs
- You’ll also be covered for a broad range of other services, like optical and dental
What is the waiting period for physiotherapy?
While waiting periods for hospital cover are set by the Federal Government, individual health insurance providers are free to set their own waiting periods for extras. This means there are no hard and fast rules, but most providers in Australia impose a waiting period of two months for physiotherapy. Canstar Research says that two months is the maximum waiting period for physio imposed by providers on our database.
That said, some providers may be willing to waive certain waiting periods for extras as a sign-up incentive. If you’re considering taking out coverage, it can be worth checking the latest health insurance sign-up deals and offers, or just simply asking a provider if they’re willing to waive the wait for you.
Is physiotherapy covered by Medicare?
In most cases in Australia, Medicare does not cover out-of-hospital physiotherapy treatment, although under certain circumstances, a Medicare rebate can be available.
According to Services Australia, doctors can refer eligible patients to allied health practitioners, including physiotherapists, with a Chronic Disease Management (CDM) plan, and Medicare will provide a rebate for up to five treatment sessions per calendar year.
If you want to know more about this, you can ask your doctor or physiotherapist. Bear in mind, though, that while these five sessions may be eligible for a Medicare rebate, you may still have to pay a certain amount out-of-pocket.
Choosing health insurance with physiotherapy cover
If you’ve decided to take out private health insurance for physiotherapy, click the button to get a personalised health insurance quote. All you’ll need to do is select from a few different policy options and provide your contact details. Your quote should feature policies and their approximate monthly premium, the other general treatments they cover and any deals that may apply.
Canstar also recognises the providers offering consumers outstanding value with a 5-Star Rating as part of our annual Health Insurance Awards.
When choosing a policy, a few things to consider are:
- Cost: Price is often the first thing we look at when comparing policies. While it’s important, it’s also worth considering whether you’re sacrificing coverage in order to save a few dollars per week.
- Limits: Including a policy’s annual limit (the total amount you can claim in a calendar year), as well as sub-limits (the maximum you can claim for a single service).
- Waiting periods: Most providers will only have a two-month waiting period on physio cover, but you may be able to have this waived as part of a sign-up deal.
Partner providers: If a provider has a large network of preferred providers, or has your chosen physiotherapist as a preferred provider, you may find this beneficial. You may be able to get extra benefits from seeing a partner provider, such as a ‘No Gap’ offer (means no out-of-pocket costs) or a discount on the total cost of the session.
