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Natural Therapies for Private Health Insurance

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Anneke Van Aswegen Updated: 11 May 2020
Types of Health Insurance

If you’re considering or using natural therapies to alleviate conditions, such as anxiety, menopause or ADHD, then you need to be aware of the Government reforms that now has private health funds excluding specific alternative therapies.

From 1 April 2019, 16 natural therapies are no longer covered under private health insurance general treatments (Extras). However, select natural therapies can still be offered by health funds, for example, Chinese medicine, remedial massage and acupuncture. Whether you can claim a benefit depends on your chosen insurer and level of Extras cover you have.

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Private health insurance reforms for natural therapies

In October 2017 the Australian Government announced several changes to private health insurance. The reasoning behind this was to make private health insurance more affordable and easier to compare.

As part of these reforms, 16 natural therapies are now excluded from private health insurance general treatments (as at 1 April 2019), meaning you will no longer receive benefits for them.

Natural therapies removed from private health insurance

  • Alexander technique: An educational method that teaches posture adjustment and could improve movement.
  • Aromatherapy: The use of essential oils that claim to promote emotional and physical health and wellbeing.
  • Bowen therapy: A holistic, remedial technique that works on the soft connective tissue of the body, which is said to bring about self-healing.
  • Buteyko: A breathing technique that could help with treating asthma and similar breathing conditions.
  • Feldenkrais: An exercise therapy using mindful movement. It claims to bring awareness and lead to improved mobility, sensation, posture, as well as breathing.
  • Western herbalism: The use of plants and plant materials to create medicines that help prevent and manage diseases, drawing from herbal traditions derived from some European and American countries.
  • Homeopathy: A pseudoscientific system of alternative medicines based on the belief that the body can heal itself.
  • Iridology: A technique where the patient’s iris is observed and evaluated to assess their general health.
  • Kinesiology: A therapy that tests a person’s muscles to identify imbalances in the body and to treat them accordingly.
  • Naturopathy: Alternative therapies that incorporate a range of techniques such as nutrition, herbalism and homoeopathy.
  • Pilates: A low-impact exercise that aims to lengthen and strengthen muscles, and improve postural alignment.
  • Reflexology: A system of massage techniques that applies different levels of pressure to the feet in an attempt to relieve tension annd ‘blockages’ to promote wellness in other parts of the body.
  • Rolfing: Soft connective tissue manipulation, that supposedly improves balance in the body by aligning its ‘energy field’ with the Earth’s gravitational pull.
  • Shiatsu: A therapeutic Japanese massage technique that uses varied, rhythmic pressure on specific points of a patient’s body.
  • Tai chi: Chinese martial arts that involve a series of gentle movements to exercise the body and mind.
  • Yoga: A popular exercise based on Indian philosophy, consisting of a series of physical postures, breathing techniques and meditation in an attempt to lower stress and increase health and wellbeing.

Natural therapies still available from health funds

Natural therapy insurance is available from select Extras health cover. Depending on your health insurer and level of cover, you could claim for therapies such as:

Remedial massage

A type of massage that treats muscle soreness and immobility, often related to an already diagnosed condition. Generally, treats sports injuries and musculoskeletal related issues such as arthritis, lower back and sciatic pain.

Myotherapy

The assessment of muscles, joints and nerves to treat the source of an injury and its symptoms. This treatment is generally recommended for sports injuries or any musculoskeletal problems.

Exercise physiology

Physical exercise to help improve a person’s overall health. Generally, people who, for example, require physiology are those that suffer from obesity, asthma, cardiovascular diseases.

Chinese medicine

A range of traditional medicine practices that originate in China. Chinese Medicine generally benefits someone suffering from a chronic disorder, often of genealogical and gastrointestinal nature.

Acupuncture

Acupuncture involves the use of fine needles across pressure points on the skin. It can help people struggling with dental pain, jaw pain or nausea related to chemotherapy and other surgical operations.

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Waiting periods for natural therapy insurance

The typical waiting period for claiming natural therapies is two months after the commencement date of your policy. However, waiting periods may vary between companies. You might want to request quotes from some of Australia’s major health brands and compare their offerings.

How to get a private health insurance rebate for natural therapies

Benefits for natural treatments are available through an Extras policy. However, the therapy type and benefit amount you can claim will depend on your choice of health fund and the level of cover you purchase, for example, Basic, Medium or Comprehensive.

Health funds providing benefits for natural therapies

Health fund and policy nameNatural therapies coveredAnnual benefit limit
Bupa Top Extras 90
  • Acupuncture
  • Remedial massage
  • Chinese medicine
  • Exercise physiology
A combined limit of $500 per policy for all therapies. Sub-limits apply.
GMHBA Top Extras 75% Benefits
  • Acupuncture
  • Remedial massage
  • Exercise physiology
A combined limit of $350 per policy for Acupuncture and Remedial massage.

Exercise physiology has a combined limit with Physiotherapy of $500 per policy. Sub-limits apply.
HBF Top Extras
  • Acupuncture
  • Chinese medicine
  • Remedial massage
  • Exercise physiology
  • Myotherapy

Acupuncture and Chinese medicine have a combined limit of $350 per policy.

A combined limit of $400 per policy applies to Remedial massage and Myotherapy.

$400 per policy for Exercise physiology.
Peoplecare Premium Extras
  • Acupuncture
  • Remedial massage
  • Exercise physiology

A combined limit of $400 per policy for Acupuncture, Remedial massage and Dietetics/dietary advice. Sub-limits apply.

Exercise physiology has a $600 combined limit with Physiotherapy, Eye therapy, Occupational therapy and other services. Sub-limits apply
Medibank Top Extras 85
  • Acupuncture
  • Remedial massage
  • Chinese medicine
  • Exercise physiology

A combined limit of $400 per policy for Acupuncture, Remedial massage, Chinese medicine and Exercise physiology

NIB Top Extras
  • Acupuncture
  • Remedial massage
  • Chinese medicine
  • Exercise physiology

Acupuncture, Remedial massage, Chinese medicine and other services have a combined limit of $400 per policy. Sub-limits apply

Exercise physiology has a benefit limit of $300 per policy.

Source: Privatehealth.gov.au (February 2020)

Questions to ask your insurer before making an alternative therapy appointment

Do you need a referral from my GP?

While you are free to see alternative health carers, a referral from your GP would indicate that your natural therapy is clinically necessary. This would help should your private health insurance Extras policy cover this natural treatment, or should the treatment be eligible for a natural therapies rebates from Medicare.

What does your health insurance cover?

Private health insurance for natural therapies varies in terms of benefits and annual limits. However, generally, Top/Comprehensive Extras policies provide more benefits with higher limits.

Coverage will depend mainly on the private health fund you are with and the level of cover you choose. Generally, if your Extras policy includes alternative health therapies, you should be covered for a percentage of the costs for the initial appointment and follow-up consultations, with session or benefit limitations. Usually, alternative treatments will share a yearly combined benefit cap.

While consultations may be partially covered, alternative medicines will most likely not be covered under the Pharmaceutical Benefits Scheme (PBS)

What are the expected out-of-pocket costs?

There may be some out-of-pocket costs for specific natural therapies, depending on the type of service you use, what a practitioner charges and your policy benefits. Other out-of-pocket costs to consider include services that don’t qualify for the Private Health Rebate. Make sure you are aware of what your Extras policy covers and the benefit amount paid.

How many visits are covered annually?

Generally, maximum benefits for alternative treatments are not based on the number of visits to your alternative health practitioner, but rather a combined or stand-alone capped dollar amount.

Must you visit a provider in your preferred network?

To claim alternative treatments, the provider must be qualified and comply with Australian Government regulations. While you may be able to choose your therapist from outside your insurer’s preferred network, the benefits paid could be higher when selecting one within the insurer’s network.

What are the benefit limits?

Make sure you know the annual benefit limits per treatment, and whether the benefit amount is part of a combined limit and/or has sub-limits.

Frequently asked questions

  • How to claim natural therapies from health insurance?

    There are a few different ways of claiming your private health insurance rebate for natural therapies, including:
    • Claim on-the-spot by swiping your membership card at the electronic claiming terminal or HICAPS. You then pay the remaining balance.
    • Claim online by logging in to the health fund’s membership portal and following the instructions.
    • Download the app: Use your smartphone to download your health insurer’s claiming app and submit your receipts and documents via the app.
    • Manual claiming: Fill out a healthcare insurance claim form, which you can download from the insurer’s website, attach your invoice and receipts and post it to the insurer or deliver it in person to their address.
    Before you go for treatment, check with your health fund to see if they have a preferred provider which may give you a discount or a higher percentage back.
  • Does health insurance cover naturopathy?

    No, not anymore. Naturopath health insurance has been discontinued after the Government reforms were actioned on 1 April 2019. Naturopathy now falls within the list of 16 excluded natural therapies for private health insurance.
  • Is naturopathy covered by Medicare?

    No, naturopathy services and treatments are not part of the Medicare Benefits Schedule, and thus no rebate can be claimed.
  • Does private health insurance cover acupuncture?

    Yes, acupuncture is seen as a viable natural treatment and is usually available from Extras health insurance policies that include this benefit.
  • Does Medicare cover remedial massage in Australia?

    Medicare does not pay a rebate for remedial massage. However, cover for remedial massage is generally available from select private health insurance policies (Extras cover). However, it depends on your choice of health fund and level of cover.
  • What’s the best private health insurance for natural therapies?

    The best Extras policy that covers alternative treatments and medicines, generally, depends on your requirements and budget. You might want to compare plans offering cover for natural therapies.

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