How does health insurance work for Physio?
"Private Health insurance" means you pay money to a Private Health Insurance fund on a regular basis, and then they provide 'rebates' on specific services, so you only have to pay part of the total cost of the service. See list below of examples of Private Health Insurance Funds.
In your Private Health Insurance, you will have chosen one of these options, or both:
'Extras' or 'ancillary' cover generally includes a rebate for physiotherapy. Depending on the level of cover you have, the amount of that rebate will be different. Some funds pay a percentage of the total fee (i.e. 30%, 40% or 50% of the total fee), while others have a set rebate amount (e.g. $40 rebate for all standard physiotherapy consultations).
So how much will it cost for me to see a Physiotherapist?
This varies for everyone, and depends on the level of Health Insurance cover you have, as well as the severity of your injury.
First, call your health fund, and ask how much rebate you will get for:
T500 Initial Consultation with a Physiotherapist
T505 Follow-up Consultation with a Physiotherapist
For some Health Funds, we are able to provide you with a 'Quote', which will tell you the exact rebates for your level of cover. Please call 8376 8816 to find out if your health fund allows this.
Second, attend your physiotherapy appointment, and bring your health insurance card with you. We will claim your rebate through our 'On-the-spot Hicaps claim system', then you just pay the remaining amount, also known as 'The Gap'.
If you don't bring your health insurance card, you will have to pay the full fee, but your health fund will still pay your rebate, when you send the invoice to your health insurer, or often you can claim online.
If you don't have health insurance, you're still able to see a physiotherapist for as much treatment as you need, and the fee remains the same, but you won't get any rebate.
Third, at your Initial Appointment, your Physiotherapist will explain your Recommended Treatment Plan, so you have a clear idea of how much treatment you might need, and how long it should take to get better.
Things that will likely be covered by your Private Health Insurance (Extras Cover)
Pilates (if instructed by a physiotherapist)
Things not covered by your Private Health Insurance
Things that MIGHT be covered by your Private Health Insurance
Compression recovery shorts (for post-natal recovery, or post-operative recovery
Health Insurance can be confusing, so please don't hesitate to call and discuss any questions you have. We're here to help you understand how it works, so you can make the best decision for your health.
Private Health Insurance Funds include (and can all be claimed 'On-The-Spot at our HICAPS terminal):
If your health fund is not on this list, please call us to discuss if you're able to claim your rebate 'On-The-Spot'.
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Aspire Physiotherapy SA
18 Partridge St
Glenelg SA 5045