True Chiropractic Heidelberg • Chiropractic Blog
Does Private Health Insurance Cover Chiropractic in Australia?
Most Australians are unclear on exactly how their extras cover applies to chiropractic. Here is a plain-language explanation of how it works — and how to maximise your benefits.
Written by Dr Nicholas Lee • AHPRA Registered Chiropractor • True Chiropractic, Heidelberg VIC 3084
How it works
Private Health Extras Cover and Chiropractic — How It Works
In Australia, chiropractic care is covered under the extras (ancillary) component of private health insurance — not hospital cover. If you have hospital-only cover, chiropractic is not included.
If you have extras cover, chiropractic is included in almost all policies that cover allied health services. The amount you receive back per visit — and the annual limit — varies by fund and by the level of extras cover you hold. Basic extras policies may pay $20–$30 per visit. More comprehensive extras policies may pay $40–$60 or more per visit, up to an annual limit that ranges from around $300 to $600 depending on your policy.
What Is HICAPS?
HICAPS (Health Industry Claims and Payments Service) is the electronic system that allows your private health rebate to be claimed instantly at the point of service, similar to how EFTPOS works for retail purchases. You swipe your health fund card at the terminal, the rebate is calculated and deducted from your gap payment, and you only pay the difference on the day.
True Chiropractic has HICAPS on-site. You do not need to submit a claim separately, it is processed at the time of your appointment. Bring your health fund card (or the digital card in your fund’s app) to each visit. Alternatively we can also send you a copy of your invoice to claim it at home if you don’t have access to your card at the time of your appointment.
Does Medicare Cover Chiropractic?
Standard Medicare does not cover chiropractic care. However, there are two specific pathways where Medicare may contribute:
• Chronic Disease Management (CDM) Plan — if your GP puts you on a GP Management Plan for a chronic condition, you may be eligible for up to 5 allied health visits per calendar year with a Medicare rebate. The rebate is currently (July 2026) $63.4 per session. Ask your GP whether you are eligible.
• Department of Veterans’ Affairs (DVA) — eligible DVA cardholders can receive chiropractic care covered by DVA for accepted conditions. Contact DVA or discuss with your GP for eligibility and referral requirements.
Making the most of your cover
How to Maximise Your Private Health Benefits for Chiropractic
Check your annual limit and reset date
Most health fund extras limits reset on 1 January each year. If you have unused chiropractic benefits remaining at the end of the calendar year, they are lost and do not carry over. Call your fund or log in to their app to check your remaining annual limit and how much you have used.
Know your gap
The gap is the difference between the consultation fee and your health fund rebate. At True Chiropractic, the gap varies depending on your fund and your level of cover. If you want to know your likely out-of-pocket cost before booking, call your fund and ask for the rebate for chiropractic item numbers 1001 (initial consult), 1006 (extended consult), and 1005 (standard consult). We can provide the relevant item numbers on request.
WorkCover and TAC
If your injury is a workplace injury covered by WorkCover Victoria, or a motor vehicle accident covered by TAC, chiropractic care may be covered under those schemes rather than your private health insurance. Contact the clinic before your first appointment and we can advise on the relevant documentation required. At True Chiropractic we unfortunately do not take on workcover or TAC patients.
Frequently asked questions
Common Questions About Health Cover and Chiropractic
Do I need a referral to use my private health extras for chiropractic?
No — for private health extras, you book directly and claim through HICAPS at the time of the visit. A GP referral is not required. The only exception is the Medicare CDM pathway, which does require a GP Management Plan.
Which health funds have the best chiropractic cover?
Cover varies significantly between funds and between tiers within the same fund. Generally, comprehensive extras or top extras tiers offer the highest rebates and annual limits. Some funds (particularly not-for-profit funds) tend to offer more generous allied health coverage than others. The best approach is to call your fund, provide the chiropractic item numbers, and ask for the rebate amount and annual limit.
Can I claim for multiple chiropractic visits in the same day?
Generally no — health funds typically allow only one claim per provider per day. If you have appointments with two different practitioners on the same day, you can claim for both, but two visits to the same chiropractor on the same day would typically only allow one claim.
Book an assessment in Heidelberg
See Dr Nicholas Lee at True Chiropractic
Dr Nicholas Lee • BSc, BHSc/BAppSc (Chiropractic) • AHPRA Registered • 9 years clinical experience
True Chiropractic is located at 124–126 Mount Street, Heidelberg — 2 minutes from Heidelberg Station. Same-week appointments available. No referral required. HICAPS on-site.
Ready to Get Assessed?
True Chiropractic • 124–126 Mount Street, Heidelberg VIC 3084 • No referral needed • Same-week appointments
Important: The information in this article is general in nature and is not a substitute for professional health advice, diagnosis, or treatment. True Chiropractic complies with AHPRA guidelines for health practitioner advertising.