Podiatry services in Australia are covered by Medicare, but there are specific eligibility criteria and conditions that need to be met. Here’s a summary of the key points:

 

    1. Eligibility Requirements: To access Medicare benefits for podiatry services, a referral from a General Practitioner (GP) is typically required. This referral is necessary for treatment related to a chronic medical condition affecting the feet. Chronic conditions might include issues like diabetes, arthritis, or other long-term ailments impacting foot health.

    1. Team Care Arrangements and Enhanced Primary Care Plans: GPs can develop Team Care Arrangements and Enhanced Primary Care (EPC) plans for individuals with complex care needs, which can include referrals to podiatrists. This is part of a broader approach to managing chronic health conditions.

    1. Limitations on Coverage: Medicare coverage for podiatry services may have limitations on the number of sessions and the specific types of services covered. It is advisable to discuss these details with your GP and podiatrist to understand the extent of coverage for your specific needs.

    1. Medicare Benefits Schedule: According to the Medicare Benefits Schedule (MBS), Medicare benefits are available for up to 5 allied health services per patient per calendar year, if clinically indicated. This can include podiatry services, and the services can be a combination of different types of services, such as podiatry and physiotherapy.

    1. Types of Services Covered: Medicare typically covers services related to chronic medical conditions like plantar fasciitis, achilles tendinopathy, or other musculoskeletal conditions. The specific types of podiatry services covered under Medicare can vary, so it’s best to consult with a healthcare provider for details.

    1. Rebate Information: Under the Chronic Disease Management plan, you can receive a rebate for podiatry consultations, with a limit of up to 5 allocated visits in a calendar year. However, it is not permissible to use both a CDM and private health care simultaneously to reduce out-of-pocket expenses further.

    1. Private Health Insurance: Many Australians also choose private health insurance to complement their Medicare coverage. Private health insurance plans often provide additional benefits for podiatry services, offering more comprehensive coverage and flexibility.


In Conclusion

While podiatry services are covered by Medicare in Australia, it’s important to work closely with your GP to determine eligibility and understand the specific services covered under Medicare for your podiatry needs. Regular reviews and consultations with healthcare providers are encouraged to effectively manage podiatry care under Medicare.