Pilates and Private Health Rebates

Pilates and Private Health Rebates – Can I claim for Private Health Insurance rebate with Hi-Life Pilates?

Interested in Clinical Pilates to help you with your injury? Looking to lengthen, strengthen or rehabilitate your body and wondering whether you can claim private health rebates for Pilates? Due to recent regulatory changes to Natural Therapies cover, the answer, unfortunately, is no. As of 1 April 2019, Pilates – alongside yoga, naturopathy and reflexology – is no longer rebatable under any private health insurance extras policy.

There is a loophole though. You may still be able to receive rebates if the Pilates session is conducted by a physiotherapist. Confused? Let me try to explain:

Changes to Natural Therapies cover
Recent government reform to private health insurance has seen the removal of 17 items previously listed under Natural Therapies. Therapies like Pilates, homeopathy, naturopathy, reflexology, iridology, shiatsu and yoga have been removed from extras policies.

The changes came into effect 1 April 2019, with the Department of Health stating there is insufficient evidence of the efficacy of the excluded therapies, which is a load of BS as there’s lots of evidence.

Clinical Pilates & Private Health Rebates
Prior to April 2019, you may have seen advertising around physiotherapist-led Clinical Pilates classes. Where private health insurance rebates were previously available for these sessions, this is no longer the case. Benefits cannot be paid for any session consisting solely of Pilates exercises, regardless of who is delivering it (instructor or physiotherapist).

Clinical Rehabilitation & Private Health Rebates
While Pilates is excluded, the Department of Health does consider “an insurer may lawfully pay benefits if a physiotherapist, providing services to a patient within the accepted scope of clinical practice, uses exercises or techniques drawn from Pilates as part of that patient’s treatment as long as the exercises or techniques are within the accepted scope of clinical practice.”

To put it simply, Clinical Rehab classes are rebatable under private health physiotherapy cover only if these active rehabilitation sessions are designed, structured and led by a physiotherapist and:
   

  • are conducted only following a comprehensive individual physiotherapy assessment with each client
  • are highly individualised, meaning each client has a personalised program tailored to their biomechanics, pathology and unique movement goals
  • allow clients with injury, pain or dysfunction to engage in a dynamic and personalised rehabilitation program
  • include the use of Pilates techniques and equipment (for example reformers, magic circles, foam rollers, spine correctors)
  • require regular reviews to monitor progress and therapeutic outcomes
  • are the safe way to benefit from a clinically-appropriate movement practice

These are exactly what I do as I’m qualified in Clinical Pilates, but I’m not a physiotherapist. So if you’re thinking of getting Private Health Rebates, you won’t be able to do so with me. You’ll have to look for a physiotherapist that is also qualified in Pilates and offers Clinical Pilates.