Your Guide to Coverage and Eligibility
If you’re looking to see a chiropractor but are concerned about the cost, you may wonder if Medicare can help. This page explains how Medicare rebates work for chiropractic services. This article will help you know how you can take advantage of them.
Medicare is Australia’s public health insurance system. It helps cover the cost of many healthcare services. Medicare does not cover treatment for everyone. There are some cases where you can get a rebate for these services. Knowing how this works can help you save on out-of-pocket expenses.
General Coverage: Normally, Medicare does not cover the cost of chiropractic services. There are exceptions through the Chronic Disease Management (CDM) Plan.
Chronic Disease Management (CDM) Plan: This plan is for those with chronic or complex health condition. If you suffer from these issues, you might be eligible for a CDM Plan. This plan is designed to help manage long-term conditions. If your GP creates a CDM Plan for you, it may include rebates for chiropractic care.
Chronic Conditions: To qualify for a CDM Plan, you need to have a long-term health condition. This may include conditions like chronic back pain, arthritis, or other musculoskeletal problems. Your GP will decide if your condition qualifies.
Referral Requirement: You need a referral from your GP to be eligible for the Medicare rebate. Your GP will assess your condition and, if suitable, refer you for chiropractic services under a CDM Plan.
Claim Process:
1. Visit your GP to discuss your condition. If eligible, your GP will create a CDM Plan and refer you to a chiropractor.
2. Book an appointment with the chiropractor and inform them about your CDM Plan.
3. After your chiropractic session, you can claim the rebate from Medicare. The clinic might assist you with this process.
Direct Billing: Some clinics offer direct billing, where they charge Medicare directly. In this case, you only pay the gap fee at the time of your appointment.
Can I claim a rebate without a referral? No, you need a referral from your GP and a CDM Plan to claim Medicare rebates for chiropractic services.
How do I know if I qualify for a CDM Plan? If you have a long-term health condition that requires ongoing care, speak to your GP. They will assess your condition and determine if a CDM Plan is appropriate for you.
How many chiropractic sessions are covered under Medicare? Medicare covers up to five allied health services per year, which may include chiropractic sessions.
We’ve compiled a list of frequently asked questions to help you understand our services. Whether you're new to chiropractic care or looking for more information, we're here to help!
On your first visit, you can expect a thorough consultation and assessment with one of our chiropractors. We will take the time to discuss your health history, current concerns, and any specific symptoms you may be experiencing.
This may include a physical examination to assess your posture, range of motion, and spinal alignment. The goal is to understand your condition fully so we can recommend the most suitable course of action. Treatments are not typically performed during the first visit unless it's deemed appropriate after the assessment.
Yes, we may offer x-rays as part of our diagnostic process, depending on your condition. X-rays help us gain a clearer picture of your spinal alignment and identify any underlying issues that might not be immediately visible through a physical exam alone.
An x-ray may be recommended if you’ve had a recent injury, are experiencing significant pain, or if there are concerns about structural abnormalities in your spine.
At our clinic, we strive to make chiropractic care accessible, but we do not currently offer bulk billing services. However, we can assist you in understanding your health insurance coverage and any out-of-pocket expenses you may incur. It’s always a good idea to check with your private health insurance provider to see what chiropractic benefits may be available to you.
Yes, we offer chiropractic care for the whole family, from children to adults. Our chiropractors provide gentle and personalised treatments designed to meet the needs of each family member, helping everyone maintain their spinal health and overall well-being.
Whether it's preventative care or addressing specific concerns like back pain or posture issues, our family chiropractic care may benefit people of all ages.
In certain cases, chiropractic care may be covered under Medicare’s Enhanced Primary Care (EPC) program, also known as Chronic Disease Management (CDM). This program provides patients with chronic conditions access to a limited number of treatments with allied health professionals, including chiropractors.
Your GP must refer you for treatment under the EPC program, and the number of sessions covered is limited. Please check with your GP and our clinic for more details on eligibility and coverage.
No, chiropractors are not licensed to prescribe drugs or medications. Chiropractic care is a drug-free and non-invasive approach to health, focusing on natural treatments such as spinal adjustments, exercises, and lifestyle advice.
If medication or additional medical treatment is required, your chiropractor may refer you to an appropriate healthcare provider.