What is Health Fund Rebate?
At present, approximately 50% of Australians have private health insurance. The reason behind this, is two-fold.
Firstly, it allows the person greater flexibility when it comes to deciding what hospital they visit and which doctor they can see. And secondly, it can help individuals to avoid paying more in tax (1).
Obviously, the choice is yours on whether you decide to take out insurance, but if you do, it’s wise to know what is included in each level of cover.
Most fund will offer a basic level which includes hospital cover only. Or you can also opt to have cover for non-medical health services, otherwise known as ancillary services, or “extras cover”. These include treatments such as dental, optical, remedial massage, chiropractic, osteopathy and physiotherapy (2).
In the event that you need to visit hospital or one of these ancillary practitioners, the private health fund will often cover a portion of the fee (the rebate), leaving you to cover the rest, known as “the gap”.
Why Do Some Practitioners Offer Remedial Massage Health Fund Rebates and Others Don’t?
There has been some controversy in recent years about who can offer remedial massage health fund rebates.
In 2009, it was found that there were some establishments offering remedial massage health fund rebates for sexual services (3).
This resulted in a massive review of the system – with one of the biggest health funds, Medibank Private clamping down on who is eligible to offer a rebate (4).
There are strict criteria for therapists to comply with to be able to offer remedial massage health fund rebates.
- hold the Cert IV or Diploma of Remedial massage
- be registered with a professional association
- have a valid First Aid Certificate,
- have their own public liability and professional indemnity insurance
- engage in continued practitioner education (5).
What Health Funds Cover for Remedial Massage?
There are at least 30+ private health funds on the market.
Some are industry funds – such as Doctors Health fund, Navy or Teachers Health. This means that you must be related to someone in the industry or work in the industry yourself to qualify.
And then there are public funds available to join as well – the larger and more well known ones are:
- AHM (Australian Health Management)
- Australian Unity
- GU (Grand United) Health
- Medibank Private and
Some work places also have corporate funds available for their employees to join.
At present pretty much all funds will cover for remedial massage under their extras cover, but this may be subject to change.
We strongly suggest that you do your research as to which fund is best for your situation. Make sure that you are familiar with what they do and don’t cover so that you won’t get caught out.
Websites such as www.privatehealth.gov.au or www.choice.com.au are great if you would like to more information. Other “free” websites such as www.finder.com.au or www.iselect.com.au are also good comparison websites. These sites often earn a finder’s fee from the fund to be listed or when someone takes out cover with them.
How Much Can I Claim for My Remedial Massage Health Fund Rebates?
If you have elected to have “extras cover”, remedial massage will most often fall under the category of natural therapies.
Depending on the fund, there are two ways that your rebate is calculated. It can be either:
- paid as a set amount per visit or
- it is a percentage of the total cost of the massage.
The amount that you will be able to claim is dependent on the fund itself. Each private health fund will set their own limits for natural therapies and you will need to check with each fund individually.
Some funds can bundle all the extras into a lump sum that so that you can choose what you need to use it on most. Other funds will have a set limit for each category (eg. Optical, Osteo or remedial massage etc.) that you can claim within the year.
While most funds run from January to December, some funds may be based on a calendar year. They may also start on the date that you joined the fund (or company that you work for).
Once you have used up the allocated amount for the year, your benefit limit will be reached. This means that you will have to wait until next year to claim again.
How Do I Claim My Rebate?
If you have a private health insurance and your fund is registered with HICAPS you will be able to claim your rebate instantly using your private health fund card.
Like a credit or debit card, we can swipe it through the EFTPOS terminal and the fund will pay the rebate to the clinic immediately. All you need to do, is the cover “the gap” which is the amount still owing.
What Happens if I’ve Forgotten My Card?
If you don’t have your card with you for your visit, no stress! All you have to do, is cover the full amount and we will email you a receipt that you can present to your fund to claim your rebate.
In most cases, this can be done online, using your health fund app, or by visiting a branch. We suggest that you contact your fund directly to see what options they offer.
Typically, you will be paid the rebate amount straight into your bank account within 5 days of submitting your receipt.
Most funds will also ask you to hang on to your receipt for 2 years. This is why we prefer to email our clients their receipts rather than give a hand-written one.
Are There Any Restrictions to Claiming Remedial Massage Health Fund Rebates?
Yes. Your private health fund rebate is for your use only which means that you cannot claim a rebate for a session that is used by someone else.
Nor can you use another person’s name on your card to claim for your session.
You also cannot buy a gift voucher and try to use your private health fund to claim against it.
If you have any further questions about remedial massage health fund rebates, please contact your fund directly or visit www.privatehealth.gov.au.
Rest assured – at Sydney Remedial Massage, all of our therapists are fully qualified and registered. This means that you will be able to claim your visit with us if you are eligible for a remedial massage health fund rebate.
If you’d like to make an appointment, you can book online or feel free to call us on 02 8021 8430.
Article by Melanie Yeoh, Sydney Remedial Massage.