
If you’ve ever experienced a foot or ankle problem, you’ll know how much of an impact such an injury or condition may have on your daily life. A podiatrist may assist with alleviating pain and improving mobility, but may be quite cost-prohibitive for a lot of people. While Medicare may cover some costs, private health insurance may help to take the financial pressure off.
With more than 30 years of experience, the team at Doubleview Podiatry is well-equipped to handle a wide range of foot and ankle issues. We work with Medicare and private health insurance funds to ensure that your out-of-pocket costs are as minimal as possible.
Is Podiatry Covered by Medicare?
Yes, some or all of your podiatry visit may be covered by a Medicare rebate, provided you meet specific criteria set out by Medicare and have been approved by your GP (based on their professional discretion and clinical assessment of your condition).
The Medicare Benefits Scheme (MBS) allows GPs to coordinate with at least two other providers (including podiatry) regarding the healthcare of patients suffering from chronic or terminal conditions. This is known as a Chronic Disease Management (CDM) plan.
A chronic medical condition is defined as one that has been or is likely to be present for 6 months or longer (such as plantar fasciitis, Achilles tendonitis, and other musculoskeletal issues). While there is no list of eligible conditions, the CDM plan is designed to assist those who require care from multiple practitioners.
What Does the Chronic Disease Management Plan Cover?
Under the CDM plan, patients are eligible for up to five podiatrist visits in a calendar year and will receive a rebate (currently $60.35) for each consultation. Doubleview Podiatry can reimburse this rebate for you on the spot at the time of your consultation so you don’t have to wait.
Is Podiatry Covered by Private Health Insurance?
Most people will need to take out an extras policy to have podiatry covered under their private health insurance. This will often give you access to a range of other services (such as optical, dental, and physiotherapy) that may make the added cost of the policy worth it.
When comparing extras health insurance policies for podiatry coverage, there are a few things to consider:
- How regularly do you visit the podiatrist?
- What percentage of the treatment cost can you claim? Are you willing to pay a higher monthly premium to receive a higher percentage of the cost back from your insurer?
- What are the limits for podiatry benefits?
- Is your podiatrist affiliated with a particular insurer? Do healthcare providers in your area offer free treatments through specific insurers?
- What is the waiting period before you can make a claim?
Before booking a podiatry consultation, we recommend contacting your insurer to determine how much of the cost will be covered. This will vary depending on the fund, level of cover, and your specific condition.
What’s the Waiting Period for Podiatry Treatment?
Insurers impose waiting periods to prevent people from signing up for coverage, getting the treatment they need, then cancelling their policy. When it comes to podiatry consultations, the typical waiting period is 12 months for pre-existing conditions and two months for new conditions. There are often specific waiting periods for podiatric surgery as well; these will vary depending on your insurer, level of cover, and specific injury or condition.
What About Podiatric Surgery?
Podiatric surgery is sometimes used to treat injuries and long-standing issues, such as:
- Bone spurs.
- Bunions, hammertoes, flat feet, and other structural issues.
- Fractures, sprains, and breaks.
- Heel pain.
- Nail conditions (like ingrown toenails).
- Nerve problems (like Morton’s Neuroma).
Medicare does not cover foot surgery performed by a podiatrist, however, there may be exceptions to this if you suffer from a chronic condition (like diabetes) and your GP has placed you on a CBM plan. In this case, the MBS may cover part of the treatment.
Surgery is usually covered by an extras health insurance policy, but remember that you may also need hospital cover.
Ensure That Your Feet Are Covered with Medicare and Private Health Insurance
Through the use of both Medicare and private health insurance, you can rest assured that your feet will be well taken care of. Whether you require a few sessions with a podiatrist, podiatric surgery, or extensive consultations to treat a chronic issue, the combination of Medicare and insurance will ensure that you aren’t out of pocket too much.
Please note that you are not able to use both a Chronic Disease Management plan and private health care at the same time. If you have a CDM plan, you can begin using your private health cover once your allocated podiatrist visits are completed.