Private Health Insurance & Exercise Physiology
Can I Claim EP Sessions on Private Health?
Many private health funds offer rebates for Exercise Physiology under their extras cover. It may be under it's own category, combined with Physiotherapy or other therapies.
The amount covered depends on your policy. We recommend calling your insurance company to determine if you have cover for the below codes.
Your insurance company generally covers a percentage of the total cost, unfortunately we do not know how much as each company is different, we recommend checking this with your insurance company too.
The HICAPS codes for Exercise Physiology are:
- Initial Appointment - 102
- Standard Consultation - 202
- Group Session - 502
You will be charged the gap fee after the claim has been processed.
Please note that if you do not have the relevant cover at the time of payment due, you must pay the full fee.
Does it matter if the EP is registered with my health fund?
Yes. To be eligible for a rebate, the Exercise Physiologist must be recognised by your health fund.
Most insurers require EPs to be accredited with Exercise & Sports Science Australia (ESSA) and have a Medicare provider number.
Before booking, it is a good idea to confirm that the provider meets your fund’s requirements.
Are there limits per year on how many sessions I can claim?
Most health funds have annual limits on Exercise Physiology services. This is usually just capped dollar amount per year, however some have set number of sessions.
It is best to check with your insurer, you can usually check how much you've used through the insurer's online portal.
How Do I Claim a Rebate?
The clinic has HICAPS, which allows rebates to be processed on the spot using your health fund card. You will then only need to pay the gap amount.
If you do not have your card or the HICAPS terminal is not available, you will need to pay for the session and then submit the receipt we send you to claim directly with your health fund.
This can usually be done online, through a mobile app, or in person at a branch.
Which Health Funds Cover Exercise Physiology?
All health insurers do. These include but are not limited to: Medibank, Bupa, HCF, NIB, and HBF.
Policies and rebate amounts vary between providers, so it is always best to check with your health fund to confirm your level of cover and any claiming requirements.
If you are unsure about your private health insurance coverage for Exercise Physiology, get in touch with us. We can help you navigate your options and ensure you get the most out of your benefits. Book a session today!
Any questions you have about using Private Health Insurance at Ares Strength Rehab, please send us a message or call (03) 8840 6566.