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Claiming your Classes through Private Health Insurance

Private Health Reforms

You may have heard about the recent changes to what private health insurers are covering. Please see the below information for how it affects you.

What are the changes?

Some natural therapies are no longer recognised as providing any evidence of better health outcomes, and so will be no longer covered from the 1st of April, 2019. Check with your fund as to what is no longer covered.

 

How does this affect me?

Physiotherapy will still be covered as it is recognised as evidence based, high value care. Initially, it was announced Pilates would not be covered, regardless of who delivers it, including physiotherapists. However, the government has come to the conclusion that physiotherapy is physiotherapy and that therapeutic exercise is beneficial. Using Pilates based exercises in a therapeutic manner is simply another treatment tool. 

Are Remedial Exercise classes covered?

This class was previously titled ‘Clinical Pilates’. But this name had to be changed to reflect the recent changes. If you are currently in a Remedial Exercise class, you are entitled to claim a rebate when:

          • you attend an initial consult

          • you are treating a current health condition or injury

          • the class does not consist solely of Pilates exercises

          • you attend regular review consultations (most funds require at least yearly) to assess your progress

          • your condition/injury is showing signs of improvement by attending the classes

          • you are covered to claim under code ‘560’ (Group Exercise)

What if:

  • I am not treating a current health condition or injury?

  • my condition resolves in the Remedial Exercise class?

  • my condition plateaus in the Remedial Exercise class?

You are more than welcome to continue with us in our Equipment Pilates class. We all know the many benefits exercise and strengthening has on the body. However, you will no longer be able to claim your classes through your private health insurer. If you claim unlawfully, you may have to pay the money back. 

What about mat classes?

The current changes have no impact on Mat classes at Balanced as they do not meet the requirements of the private health insurance companies, and you can not claim this classes. 

If you have any further questions, please feel free to contact me on 0414 888 780 or vanessa@balancedphysiopilates.com.au