If you have private health insurance with extras cover, physiotherapy is almost certainly included. Understanding how your rebates work — and how to maximise them — can significantly reduce your out-of-pocket costs for physiotherapy care.
How Private Health Physiotherapy Cover Works
Physiotherapy is covered under the extras (or ancillary) component of private health insurance — not hospital cover. When you attend a physiotherapy session, you pay the full fee and your insurer reimburses a portion (the rebate). The difference is your gap payment. With HICAPS on-the-spot claiming, the rebate is deducted instantly and you pay only the gap at the time of your appointment.
Key Terms to Understand
- Rebate: The amount your insurer pays per session. Varies by fund and policy level ($20–$90+).
- Gap: The difference between the physio fee and your rebate — what you pay out of pocket.
- Annual limit: The maximum your fund will pay per calendar year (or policy year) for physiotherapy.
- Waiting period: The period after joining or upgrading before you can claim. Typically 2 months for physiotherapy on new policies.
- Preferred provider: Some funds have preferred provider networks — using a preferred provider may increase your rebate. Check whether Better Physiotherapy Bundoora is in your fund's preferred network.
HICAPS On-the-Spot Claiming
Better Physiotherapy Bundoora has HICAPS available for on-the-spot claiming. Bring your private health insurance card (or digital card in your fund's app). At the end of your appointment, we swipe your card through the HICAPS terminal, your rebate is confirmed and deducted immediately, and you pay only the gap. No forms, no waiting for reimbursement.
Maximising Your Cover
- Use your Medicare EPC allocation (5 bulk-billed sessions per year) first, then claim private health for additional sessions
- Check your annual limit in January — most limits reset at the start of the calendar year
- If you have reached your annual physio limit but need more sessions, ask your fund whether the sessions can be claimed under a different allied health category (e.g. myotherapy or remedial massage)
- If you are planning major surgery, maximise your pre- and post-surgical physiotherapy within your calendar year
What If I Don't Have Private Health Insurance?
Medicare EPC bulk billing (5 free sessions per year with GP referral) and other funding pathways (NDIS, WorkCover, TAC, DVA) are available. See our bulk billing guide for a full breakdown of all funding options.
Frequently Asked Questions
How much does private health insurance cover for physio?
Rebates vary significantly between funds and policy levels. Budget extras policies may cover $20–$30 per session with low annual limits. Mid-tier policies typically cover $40–$60 per session. Top extras policies can cover $60–$90+ per session with higher annual limits. Check your specific policy or call your fund.
What is the annual limit for physiotherapy on private health?
Annual limits vary by fund and policy. Budget policies may have $200–$400 per year; comprehensive extras can be $500–$1,000+ per year. Annual limits reset on 1 January for most funds (some reset on your policy anniversary date).
Can I use both Medicare and private health for physiotherapy?
Not simultaneously. For Medicare EPC (bulk billing), the session is billed entirely to Medicare and there is no gap to claim on private health. For private physiotherapy (non-EPC), you can claim your private health rebate. Most patients use Medicare EPC for their 5 bulk-billed sessions per year, then use private health for additional sessions.
Do I need to bring anything to claim on private health?
Just bring your physical private health insurance card or your fund's app with a digital card. We process HICAPS on-the-spot — the rebate is deducted immediately and you pay only the gap.
Ashley Haleel
Physiotherapist & Owner — Better Physiotherapy Bundoora