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is podiatry covered by medicare? yes.

Is Podiatry Covered By Medicare?

Is Podiatry Covered By Medicare?

As an Australian I’m so proud of our achievements on the world stage. 

Punching above our weight in the Olympic medal tally. 8th!

Being integral in the moon landing (re-watch the Dish!). 

Not cheating at sports (ok, except for using sandpaper and bowling underarm). 

And Medicare, a world leading health funding instrument which has helped shape the health and well being of our nation for the last 30 plus years.

When initially implemented Medicare paid for your medical (hospital and doctor) related expenses. Fast forward to the 2000’s and we have more and more evidence that spending money and time with allied health like podiatrists, physiotherapists and exercise physiologists was as just, if not more beneficial for your health than only seeing your GP. 

This is when some Medicare benefits became available for allied health services like podiatry. 

Now, there are some restrictions around who and when you can see a podiatrist and obtain a Medicare rebate. Couple this with podiatry being a profession that helps so many with so much. From sports injuries to skin and nails, to diabetes and other health conditions it’s no wonder working out if you get a medicare rebate for your podiatry needs can be tricky.

Let’s walk you through the process to see if you get a Medicare rebate for your podiatry session.

The first step in accessing Medicare for podiatry is a visit to your GP. There’s this little thing called a Chronic Disease Management (CDM) Program – commonly referred to as a Team Care Arrangement (TCA) or an Enhanced Primary Care (EPC) Plan.

A CDM Program/TCA/EPC Plan (say that 10 times fast) can be organised for you by your GP if you suffer from a ‘chronic’ condition, often classified by the duration of said condition being greater than 3 months. 

At your GPs discretion, a CDM Program will allow you to claim up to 5 medicare rebates for podiatry per calendar year. As of mid-2019, this rebate will cover $53.80 of your consult, if you have exceeded your medicare safety net then you will get back even more. There are a few tricky hurdles however.

You can only claim 5 medicare rebates for ALL allied health in a calendar year. 

Also, you cannot part-pay with your medicare rebate AND your private health insurance, it has to be one or the other. For some people this means that they’re better off using their private health insurance, others, their medicare rebate.

a flowchart explaining how podiatry is covered by medicare

So to summarise, Medicare sometimes covers podiatry. 

In order to receive a rebate, you must have an organised CDM program by your GP addressed to your PridePlus Health podiatrist. Medicare will only provide you with your rebate if your paperwork is in order and you have not exceeded your allied health limit of 5 consultations in the calendar year.

If you think you have a condition that should allow for a Medicare rebate for your podiatry services, have a chat to your GP!