New Year, New Insurance?

Which private health extras policy is best for me and is it worth it?

This is a question I get asked often as a physio. The truth is there is no policy that is better than any other overall, but if you can understand how to interpret the policy, then you can find out what will give you the most benefit and work best for your needs and situation. Extra’s (or also referred to as Ancillary) cover can be as cheap as a cup of coffee for the lowest/basic tier, but spending more on the top tier will give you cover for more services, higher rebates per session and higher annual limits.

Waiting Periods

Most health insurers will have a 2 month waiting period (or up to 12 months for pre-existing conditions) before you can claim rebates on physio appointments. It is not uncommon for insurance companies to have a “sale” and advertise waiving these waiting periods. If you need physio now, but don’t plan on using these services all year round, it may be worth looking for these sales or asking if the waiting period can be waived altogether.

Annual Limits and Allocated Funding For Physio/Wellness Services

When picking a policy that is right for you, it is worth writing down all the services you plan to use over the next year and looking up the summary of cover for the policy that interests you. You will find some policies combine the annual limit for multiple services, while others separate each service. 

For Example:

Policy A: for physio/massage/exercise physiology the combined annual limit is $800 

Policy B: for physio the limit is $500, for massage $500, and for exercise physiology $500

Policy C: pick any 3 services for a combined limited of $1000

Depending on the services you are likely to use (not just physio/massage, but also dental, podiatry, speech therapy, etc), this will affect which policy is best for your circumstance.

Rebates Per Appointment

Depending on the tier that you purchase, the health fund can contribute anything from $20 back per appointment to 70%+ back per appointment. You may think that the more back per appointment the better, but this also depends on the annual limit. For someone who attends physiotherapist-led clinical conditioning classes on a weekly basis as well as a monthly massage, an annual limit of $500 will disappear quickly if the rebate is 70%, whereas $20 back per session will stretch the funding across the year more evenly.

Monthly Fee

It is always worthwhile calculating how much the policy will cost annually – and if you will get your money’s worth.

Healthy Lifestyle Incentives

Some insurance policies have incentives for adopting a healthy lifestyle. A handful of health insurers are linked with “Vitality” where you can earn discounts on gym memberships or fitness devices. Others contribute to gym memberships (including online memberships, F45, pool entry fees and personal training), healthy eating programs, flu vaccines and other services to help prevent illness. For your health insurer to support these services you will likely need a letter from your doctor endorsing this service for your health and wellbeing.

If you would like to find out in advance how much of your appointment will be covered, contact your provider and quote these item codes: 

  • Physiotherapy Initial – 500
  • Physiotherapy Follow-up – 505
  • Pelvic Physio Initial/Follow-up – 593
  • Clinical Conditioning Class – 560
  • Myotherapy/Remedial Initial – 105
  • Myotherapy/Remedial Follow-up – 205

~ Nicole Reynolds, Senior Physiotherapist

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