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Private Health Insurance for Physiotherapy

If you need to visit a physiographist regularly, for example, for back pain, carpal tunnel syndrome, or arthritis, a private health insurance policy might help you reduce out-of-pocket costs.
Fact Checked

Updated: 27 May 2024

Health funds in Australia provide you with cashback when claiming physiotherapy benefits through their Extras cover. Extras health insurance provides benefits toward the cost of general treatment received outside of the hospital to help you prevent or manage injuries and illnesses.

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Who benefits from physiotherapy?

Physiotherapy increases the quality of your life by using techniques, such as manual therapies and exercise, to help improve movement and reduce pain and stiffness. Typically, physio is helpful to people with chronic diseases, older Australians, athletes, and children with challenges such as balance and coordination. Benefits generally include:

Is physiotherapy covered by health insurance?

Yes, it’s possible to get coverage for physiotherapy treatment when purchasing an eligible Extras policy from a private health insurance company. There is generally a limit on how much physiotherapy you can claim. Your annual benefit limit depends on the health fund and level of cover you choose.

What physio services are covered by health insurance?

The cover and claim amount provided by your physiotherapy benefit will depend on your specific condition, health fund and the level of cover you choose. Usually, you’ll have the option of Basic, Mid or Top Extras policy. The following services might be covered:

Compare the best private health cover for physio

Health Insurer
Annual benefit limit
Maximum benefit
ahm 100x100 1
$600 per policy.
$44 for initial visit $34 for subsequent visit
Australian Unity 100x100 1
$600 per policy.
80% for initial visit 80% for subsequent visit
bupa 100x100 2
$800 per policy.
$41.10 for initial visit $33.30 for subsequent visit
GMHBA 100x100 1
$500 per policy combined with exercise physiology and other services. Sub-limits apply.
75% for initial visit 75% for subsequent visit
HCF 100x100 1
$600 per policy combined with other services.
$60 for initial visit $54 for subsequent visit
HIF
$200 per policy combined with eye therapy, occupational therapy and speech therapy. Sub-limits apply.
$45 for initial visit $40 for subsequent visit
$600 per policy combined with other services.
75% for initial visit 75% for subsequent visit

Source: privatehealth.gov.au (29 October 2019).

Take note: This is not a comprehensive list of health funds that cover physiotherapy, but rather a breakdown of the health insurance companies we compare. The above information is based on a single adult living in Queensland applying for Top Extras cover on the 29 October 2019.

Possible limits on your physio Extras cover

The benefit amount you can claim will typically be either a percentage of the benefits, for example, 75% back on physio treatments, or a set benefit, for example, $45 back from initial physio consultations.

Carefully review the limits attached to your Extras policy. Your benefit limits will depend on your insurer and the level of coverage you choose. You can generally expect increased limits with higher Extras policies.

Does Medicare cover physiotherapy?

Yes, Medicare generally provides a rebate for physiotherapy health services for up to 5 ‘Allied Health’ consultations per calendar year if you qualify for the Chronic Disease Management (CDM) program. The CDM program is generally available to people with chronic or complex medical problems. The 5 visits restart each calendar year, but every 12 months you’ll need a new referral from your GP.

Medicare rebate qualifying conditions generally include:

Important: If you have private health insurance, you should preferably use your Medicare entitlements first, and then use your insurance rebates for any outstanding amounts.

How much does Medicare pay for physiotherapy?

Medicare generally pays 85% of the physio fee, which amounts to $53.80 per treatment for a physio consultation (October 2019).

To claim your Medicare rebate, you generally pay the full consultation fee at the time of your appointment. Your physiotherapist will then process the payment that links into Medicare, and your rebate will then be paid directly into your bank account within 1 to 3 working days. Alternatively, you might be able to claim on the spot by swiping your Medicare card on their HICAPS machine, and the rebate will be paid back into your Debit Card.

If neither of the above claiming options are available, you’ll generally need to go to the Medicare office and have them reimburse you.