Put your best foot forward this summer
If you’ve decided to seek professional help for your feet or lower limbs, it's helpful to understand what is covered under your private health insurance to help you plan for the costs associated with your treatment.
Extras cover
Consultations with a podiatrist
All our extras products include benefits for consultations with a podiatrist. A standard consultation often involves an assessment of your condition and the development of a treatment plan and may include some clinical care. To better support your treatment, our cover now includes additional benefits related to the fitting of custom orthotics, such as the initial biomechanical assessment and the creation of associated moulds or casts.
Under all of our extra's products, you’ll get a higher benefit for your first podiatry consultation each calendar year and a set benefit for all subsequent visits, until you reach your annual limit.
Your podiatrist may perform some minor procedures during your consultation, such as extracting corns, treating ingrown toenails or trimming nails. These services may be billed separately by your podiatrist and are not covered by your policy.
Orthotics
If your treatment plan includes custom-made orthotics, you can claim the devices themselves under the podiatry limit on your extras cover. Depending on your level of cover, we’ll pay a fixed benefit within your annual podiatry limit, with a maximum of two sets claimable per person each year.
You can claim for your orthotics on the spot through HICAPS or HealthPoint, or by simply sending us a photo of your receipt using the Doctors’ Health Fund claiming app.
Hospital cover
If you need surgery for your feet or lower limbs, the benefits you receive will depend on your level of hospital cover and the type of specialist performing the procedure.
Surgery for these conditions is often performed by an orthopaedic surgeon, and the benefits payable depend on the Medicare Benefits Schedule (MBS) item numbers your specialist uses. Our Gold tier policies cover all Medicare-eligible inpatient services, including clinical categories like bone, joint and muscle, joint reconstructions, and joint replacements. Our Smart Starter Bronze Plus policy includes the first two categories but excludes joint replacements.
Some foot and ankle surgeries can be performed by a podiatric surgeon. As these procedures don't have a Medicare Benefits Schedule (MBS) item number, the surgeon's and anaesthetist's fees are not covered by Medicare or private health insurance. However, if your hospital policy includes podiatric surgery and your surgeon is accredited, we may pay a benefit towards your hospital accommodation and theatre fees.
We're here to help
Understanding your cover can feel complex, so if you have any questions about your podiatry or podiatry related hospital treatment, please get in touch. We're here to help you navigate your options and make informed decisions about your health.
