Health Fund Rebate

 In General

Did you know our qualified pilates instructors are recognised through the health fund insurers.

Here are the funds and policies that do, do pilates claims

  • Australian Health Management (AHM) – Recent changes to AHM policy (notified 20/02/2017): ahm members with relevant cover can only claim a benefit towards Pilates if the service is provided by a registered Physiotherapist, or if their cover includes Health Improvement benefit and relevant supporting information is provided to AHM before a claim is made. The AHM Health Improvement form can be completed by a medical or other practitioner and can be found on the AHM website here Health Improvement form
    • ahm no longer issue provider numbers
    • ahm no longer require provider numbers to be quoted on receipts
    • Pilates cannot be claimed online, the claim must be sent to ahm by mail or email.

    For more information on how to claim follow this link and select “Can I claim exercise classes’ : Claiming on Extras

 

  • HCF – Pilates is claimable as a Health Management Program for clients with eligible HCF extras cover (clients should be advised to confirm their level of cover and available limits with HCF prior to commencement so they are clear about their eligibility to claim). They must be referred by their GP/Physio/AEP in the first instance. A Pilates exercise program that isn’t delivered by a recognised physiotherapist or Accredited Exercise Physiologist must be claimed using HCF’s Exercise and gym benefits authorisation and claim form completed by the relevant medical provider. HCF do not register non clinicians within the Health Management Program, so there is no Provider Number.CBHS Health Fund Limited.

 

  • CBHS Health Fund Limited – CBHS would like to advise that due to a change of Fund Rules Pilates now comes under our Health Management Program. Individual recognition of Pilates instructors is no longer required. CBHS members can only claim after they have a Health Management Program Authorisation Form completed by their medical practitioner and submitted to CBHS with their claim. This also applies to gym membership, yoga and personal trainers. The service provided must be to treat or ameliorate a medical condition.
  • GMF Health Fund 
  • Health Care Insurance Limited (HCILTD)
  • NIB- NIB are not issuing provider numbers. Benefits for Pilates classes From 1 April 2012, will pay a benefit for Pilates classes led by an NIB recognised Pilates instructor under the Healthier Lifestyle benefit. You’ll need to complete a Health Management form and have a health professional like a GP or Physiotherapist to confirm that Pilates is recommended for you as a part of a Health Management Program. You can download the Health Management form now from nib.com.au. Rest assured, benefit payments for Pilates classes led by a registered physiotherapist, no needs to fill out a form.

 

  • Teachers Federation Health  -Teachers Federation Health do not issue Pilates Instructors with provider numbers. Pilates classes are paid under their Healthy Lifestyle Benefits. Teachers Federation Health client/member would also need to obtain a letter from their GP confirming that attending Pilates classes will help prevent or ameliorate a specific medical condition.
  • Transport Health.
  • HBF Health Fund- When client wishes to claim, please complete and submit this HBF Provider Application form to HBF to request a provider number.

 

  • Health Partners.
  • Australian Unity – Australian Unity offers benefits under their Health Management programs if treatment is prescribed by a health official. They also have two Exclusive Lifestyle Packages: The Active Lifestyle Package and Cosmetic Lifestyle Package, which run separately to their traditional Health Insurance products.The Active Lifestyle Package has refunds for Group Exercise Classes, such as Pilates. You can find more information on their website by following this link: Australian Unity.

 

  • Medibank Private – Unfortunately Medibank do not recognise Pilates Instructors as Ancilliary healthcare providers unless they are a registered physiotherapist as well.

 

  • BUPA (Covers MBF, HBA, Mutual Community) – From 1 June 2017 pilates classes will no longer attract a benefit on Bupa products. Accordingly, Bupa will not register any further providers from 1 June 2017. Bupa state they have also communicated with individual providers and any of their customers who may be directly affected by this change.

 

Please keep in mind there has been some significant changes to the public’s ability to claim on Pilates, taking effect from April 2019.

From 2019, private health insurance will no longer cover natural therapies, including aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi and yoga.

This move comes after a recent review by the Commonwealth Chief Medical Officer found there was no clear evidence of the efficacy of these therapies.

Please be mindful that the impact for our clients may be minimal given the current rebate level.

We will keep you informed of any further changes for the near future about these health fund reforms.

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