Medicare Rebates and Private Health Insurance Cover for Osteopathic Treatment in Australia

For anyone who is considering undertaking a course of osteopathic treatment in Australia, it is crucial to know to what extent your treatment will be protected under either Medicare, the government-funded universal health plan, or by your private medical insurance. Osteopath Oakville

Medicare

A patient in Australia with a chronic condition (e. g. a long-standing musculoskeletal condition), which is being maintained by a GP, is entitled to a Medicare refund for a maximum of five sessions of osteopathic treatment in a work schedule year, as provided by an osteopath registered with the Osteopathy Board of Australia. There are, however, certain conditions that are applied for a patient to be eligible for the rebate. 

Firstly, treatment by an osteopath must be recommended by a GP who have provided MBS Chronic Disease Management services to the sufferer, and as part of the person’s GP Management Plan (GPMP) and Team Care Preparations (TCAs). A referring DOCTOR is necessary to use a recommendation form that is provided by the Australian Office of Health and Aging, and this form should be presented to the osteopath at the first treatment session. Once all five sessions have recently been undertaken, if further treatment is required, a new GP referral is required. Second, if more than five sessions of osteopathic treatment are undertaken, following sessions aren’t covered by the Medicare rebate. 1 / 3, the osteopath is necessary to provide the referring GP with a written report, usually at the conclusion of the treatment, that will detail the treatment provided, any tests or tests carried out, and strategies for future management of the patient’s condition.

A patient that has private medical insurance but who opts not to claim on that insurance for their osteopathic treatment, instead choosing to say their Medicare health insurance rebate, is also entitled to claim for the price tag on five sessions of treatment in a season, provided the above conditions are met.

Private health insurance

As osteopaths in Sydney are Allied Health Specialists, a patient for who osteopathic treatment is included in their private health insurance scheme does not require a referral from a GP to undertake a treatment. Generally speaking, a private health fund will offer either a form of ancillary or extra supplies cover that will: allow the patient to a place range of osteopathic treatment lessons within a calendar yr, depending on level of cover; or, pay a contributions towards the expense of osteopathic treatment sessions, up to an agreed amount.

However, it is important for patients to check with their health fund that osteopathy treatment is covered in their own scheme, and what other expenses they may be liable for. That is also important to know that patients who may have chosen not to state the price tag on their osteopathic treatment on the private health insurance, and have instead elected to claim their Medicare health insurance rebate, cannot use their private health insurance cover to pay any shortfall between the Medicare rebate and any fees paid for their treatment.