Health Insurance for Podiatry and Orthotics: A Practical Guide

Whether you’re managing chronic foot pain, recovering from an injury, or simply require custom orthotics to improve your mobility, podiatry care plays a critical role in maintaining lower body health. However, podiatry treatments can be costly, and Medicare only provides limited coverage when tied to chronic care plans.

This is where private health insurance with extras cover can help. By reducing out-of-pocket costs for podiatry consultations, orthotics, and related services, appropriate extras insurance makes treatment more accessible.

Here’s everything you need to know about private health insurance for podiatry and orthotics.

Does Private Health Insurance Cover Podiatry?

Yes, appropriate private health insurance can help cover podiatry services under extras policies. Typical inclusions for podiatry benefits are:

Podiatry Consultations: For conditions such as plantar fasciitis, bunions, or general foot pain.

Custom Orthotics: Shoe inserts designed to alleviate pain, improve posture, or assist in recovery from injuries.

Preventative Care: Services like physical assessments and injury management for athletes or active individuals.

What About Orthotics?

Custom orthotics are commonly prescribed for foot, ankle, or knee alignment issues, but they’re often costly, ranging from $300 to $600 per pair . With the right extras policy, insurance can:

Reimburse a percentage of the cost (e.g., 70%).

Allow claims up to a set annual cap (e.g., $500 per year).

Typical Out-of-Pocket Costs Without Insurance

The cost of podiatry treatments without private health insurance can quickly add up, particularly for ongoing care. Here’s an estimate:

Initial Podiatry Consultation - $70–$120

Custom Orthotics - $300–$600 per pair

Follow-Up Consultation - $60–$90

Extras cover can ease this financial burden, especially for those needing recurring treatment.

Real-Life Example: How Insurance Helps

Scenario: James, a 38-year-old frequent runner, suffers from chronic heel pain caused by plantar fasciitis. His podiatrist prescribes custom orthotics and ongoing consultations. Here’s how his extras cover helps:

Total cost of orthotics: $600

His policy covers 75% of orthotics costs: $450 rebate, $150 out-of-pocket

Annual limit for podiatry consultation claims: 75% up to $500

James recovers most of his 4 consultation expenses, saving $300 and paying just $100 out of pocket.

How to Choose the Right Policy for Podiatry

When comparing health insurance policies for podiatry and orthotics, keep the following factors in mind:

1. Check for Orthotics Inclusions

Not all extras policies include custom orthotics, so confirm this benefit before choosing a fund.

2. Focus on Annual Limits

Podiatry and orthotics are subject to annual caps , typically ranging from $300 to $500. Choose a policy with higher limits if you need frequent consultations or expensive orthotics.

3. Look for No-Gap Providers

Some health funds have agreements with podiatrists or orthotic clinics to eliminate or reduce gap fees entirely.

4. Understand Rebate Percentages

Policies typically reimburse between 50–75% of the cost for podiatry services and orthotics. Maximise value by choosing higher rebate percentages if possible.

5. Combine with Preventative Services

Extras insurance often bundles podiatry with services such as physiotherapy or massage therapy, which can further assist with foot and leg problems.

What should I be aware of when claiming for orthotics through private health insurance?

• Certified Supplier: Before filing an orthotic appliance claim, ensure your items are provided by a registered orthotist, orthotic supplier, or podiatrist. Confirm that your chosen supplier is covered by your health fund before making any appliance payment.

• Waiting Periods: There are different waiting periods applicable to different types of orthotics. Some health funds impose a general waiting period (e.g., 12 months), while others may have separate waiting periods for repair, maintenance, hire, and replacement of orthotic equipment.

• Check your policy fine print before signing up to a fund that might not be your best fit.

• Annual Benefit Limits: Examine your benefit limits, including an annual benefit limit for orthotics. Verify if there are dollar limits for certain orthotic devices or if your health fund covers a percentage of your bill for your orthotic appliances. Important Note: Check whether any listed annual limit includes benefits for other health aids and appliances, or will only be applied to your orthotic devices.

Orthotics is also grouped with physiotherapy, occupational therapy, dental and other allied health services, so if you regularly use more than one allied health service, it can be worth a higher level of cover.

Andrew G. Bull - Sports Podiatrist from Sydney Sports Podiatry

Cost-Saving Tips for Podiatry

Claim Preventatively: Use your podiatry benefits for assessments before small issues become bigger problems.

Maximise Annual Limits: If you require ongoing care, schedule appointments across two benefit periods to maximise claims.

Bundle Insurance Needs: Choose a policy that includes physio or preventative treatments alongside podiatry.

Seek Preferred Providers: Many insurers offer higher rebates or no-gap services if you use partner podiatrists.

Why Compare Policies for Podiatry Insurance?

Not all extras policies are created equal, and choosing the right one ensures you get the most out of your podiatry claim. Comparing health insurance policies helps:

• Identify policies with the highest annual caps for podiatry.

• Find funds that include orthotics as part of the benefit.

• Avoid unnecessary costs by selecting only the services you need.

Find Great Cover for Your Feet

From treating chronic conditions to providing custom orthotics, health insurance designed for podiatry can deliver outstanding benefits. Compare Club’s specialists can guide you to extras policies# that prioritise your needs, helping you stay active and pain-free.

Contact us today to start comparing health insurance options for podiatry and orthotics.

Frequently Asked Questions

Does Medicare Cover Podiatry Services?

Medicare covers podiatry only under chronic care plans for specific conditions. For broader access, private extras cover is essential.

Can I Claim Orthotics Through Health Insurance?

Yes, many extras policies include benefits for custom orthotics, reimbursing part of the cost. However, annual limits apply.

What Does a Podiatry Waiting Period Mean?

Most extras policies impose a two-month waiting period for podiatry benefits, meaning you can claim after holding your policy for two months.

Is Podiatry Only Covered Under Comprehensive Policies?

No, even mid-tier extras policies may include podiatry benefits. Check the details to ensure the policy aligns with your care needs.

Sources:

https://entirepodiatry.com.au

https://powerpodiatry.com.au/orthotics-cost-orthotics-price-guide/

https://www.news.com.au/best-of/money/silver-health-insurance/news-story/8d0e6f0fc6f2313729a228cfb00f61fd

https://www.ombudsman.gov.au

https://www.hif.com.au

Australian Podiatry Association

Private Health Insurance Ombudsman

Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

Meet our health insurance expert, Chris Stanley

Chris's top health insurance tips

• 1

  Australia’s public health system is world-class, but wait times for public hospitals can be long, inconvenient - and leave you living in constant pain while you wait.

• 2

  An appropriate private health insurance policy can speed up your surgery, relieving your pain sooner.

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  Family health cover means your children are covered under the same policy as you.

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  Many health insurance policies come with a 12-month waiting period for pregnancy-related cover, so it’s a good idea to get a family policy organized well before starting your family. This means your child will be covered from birth until at least their early twenties (depending on which health fund you select).