Chronic pain management is always a complex journey. It can be hard to find the ideal approach. For many people, the road to improving their quality of life involves opting for ongoing chiropractic care, which may not be covered by insurance.
The good news is that some patients may be able to access chiropractic treatment through Medicare with a valid GP Chronic Condition Management Plan (GPCCMP).
At Wholistic Health Centre, we help eligible patients understand how Medicare-supported chiropractic care works. If you have a long-term musculoskeletal condition, your GP may decide that chiropractic care should become a part of the treatment plan. Then you can work on a solution with a chiropractic professional in one of our clinics in Hurstville, Kareela, Wolli Creek, or Miranda.
If you are receiving care under the GPCCMP, we can also provide Exercise Physiology services at our Miranda branch and Physiotherapy at our Hurstville clinic.
Yes, some patients can access chiropractic care through Medicare. The two main requirements are a chronic condition and a valid GP referral.
Services Australia includes chiropractors among the allied health professionals who can provide services under a GP Chronic Condition Management Plan (used to be called EPC (Enhanced Primary Care) or CDM (Chronic Disease Management) plan)
Unfortunately, Medicare doesn’t usually cover standard private chiropractic appointments. However, Medicare support can become available if the GP determines that you meet the eligibility requirements.
The referral must be prepared by a GP or another eligible medical practitioner.
Eligible patients may access up to five Medicare-subsidised allied health visits per calendar year across all eligible allied health providers. These visits aren’tlimited to chiropractic only.
For example, your five visits could be shared between a chiropractor, physiotherapist, podiatrist, or other allied health professionals. However, you can also be eligible for 5 covered chiropractic visits.
A GP Chronic Condition Management Plan is a care plan created by your GP for a chronic health condition that requires ongoing management.
A chronic condition is generally a condition that has lasted, or is expected to last, for at least six months.
Your GP will assess your health needs and decide whether chiropractic care should become a part of that plan. It may involve several healthcare providers working together.
At Wholistic Health Centre, we work closely with your referring GP. Every patient receives a thorough assessment before treatment begins. We provide your GP with our findings and management plan (usually within 48 hours of your first appointment). If further investigations or specialist care are needed, we can also recommend appropriate referrals. This collaborative approach helps ensure everyone involved in your care is working towards the same goals.
A GP Chronic Condition Management Plan may be appropriate for people with ongoing musculoskeletal issues such as lower back pain or mobility problems.
The referral is usually valid for the period stated by your GP. However, if the healthcare provider doesn’t list a timeframe, the referral is generally valid for 18 months. The clock begins running on the date the first service is provided.
Eligibility depends on both Medicare rules and the clinic’s billing policy.
Patients with chronic musculoskeletal conditions may wish to ask their GP whether they could be eligible for a GP Chronic Condition Management Plan.
Your GP must assess whether your condition meets the Medicare requirements and whether chiropractic care is clinically appropriate for your situation.
Patients with a valid GP Chronic Condition Management Plan referral may be eligible to claim the Medicare rebate for chiropractic care.
At Wholistic Health Centre, we bulk bill eligible pensioners and retirees, which means there is no out-of-pocket cost for these appointments. Other eligible patients can still claim the Medicare rebate and simply pay the remaining gap.
If you would like to know whether any out-of-pocket costs apply, our team is happy to explain the process before you book your appointment.
Chiropractic care can help manage ongoing musculoskeletal conditions. At Wholistic Health Centre, our chiropractors often see patients with:
Our chiropractors work hard to help patients stay active in their daily lives. All our treatment recommendations are based on an individual assessment and your broader healthcare needs. We also co-manage patient care across multiple allied health disciplines within one practice.
Many people use the terms “bulk billed,” “Medicare rebate,” and “Medicare-supported” interchangeably. However, they can be drastically different.
Bulk billing means the clinic bills Medicare directly and accepts the Medicare benefit as full payment for that eligible service. At Wholistic Health Centre, this applies to eligible pensioners and retirees receiving care under a valid GP Chronic Condition Management Plan.
A Medicare rebate means you may pay the clinic fee first and then receive a rebate back from Medicare.
Other eligible patients can still claim the Medicare rebate but may have an out-of-pocket gap. If you are unsure what your appointment will cost, please contact our team before booking.
Yes, you need a GP referral if you want to claim eligible Medicare benefits for chiropractic care. However, you don’t need a GP referral to book a private chiropractic appointment.
The referral should be arranged before your appointment. These can’t be backdated. If you are unsure whether you have the correct referral, our team can help you understand what you are eligible for.
At Wholistic Health Centre, we believe that accessing healthcare should be as simple as possible while being completely transparent.
Our chiropractors work hard to help patients stay active in their daily lives. All our treatment recommendations are based on an individual assessment and your broader healthcare needs. We also work closely with your GP and other healthcare providers.
We can also help you learn how Medicare-supported care works. Our team will explain what documents you need and whether bulk billing may apply to your appointment.
If you think you may be eligible for Medicare-supported chiropractic treatment, speak with your GP and contact Wholistic Health Centre to discuss your options.
Located in Wolli Creek, Miranda, Kareela and Hurstville, we proudly serve patients across the Sutherland Shire, St. George region, and Inner West
Hurstville Wholistic Health Centre
Kareela Wholistic Health Centre
Hurstville Wholistic Health Centre
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We are happy to answer any questions you might have about starting care at our clinic. Find your closest clinic location and start your wellness journey today.
