Is Exercise Physiology Covered by Medicare?
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If you’re reading this right now, then its fair to say that you have asked the question of '“is Exercise Physiology covered by Medicare?'“ Well, you’re not alone! With the growing awareness of how essential movement and exercise are for managing a range of conditions, many people are looking for ways to make these services more affordable. The good news? In certain circumstances, yes, Medicare can help cover the costs! But, it’s not always straightforward. There are specific eligibility criteria, and understanding how it all works can be a little tricky. Don’t worry though, we’ll walk you through everything you need to know!
First Things First, What Exactly Is Exercise Physiology?
Understanding the Basics
Exercise physiology is more than just working out; it’s a science-based approach to improving your health through tailored exercise programs. Whether you’re managing chronic pain, recovering from an injury, or dealing with conditions like diabetes or heart disease, an Exercise Physiologist designs a program specifically for you.
Imagine having a personalised exercise plan that addresses your unique needs and goals. How much easier would managing your condition become with professional guidance and support? For more information about Exercise Physiology, click HERE to view our Exercise Physiology webpage.
Does Medicare Cover Exercise Physiology?
Exploring Your Medicare Options
The good news is that Medicare does cover Exercise Physiology services under specific conditions. If you have a chronic medical condition and complex care needs, you may be eligible for coverage through the Chronic Disease Management (CDM) program.
Who Is Eligible?
To qualify for Medicare Exercise Physiology services, you must:
Have a chronic condition lasting at least six months (or a condition that is likely to be present for at least 6 months), such as chronic pain, diabetes, or cardiovascular disease.
Have a Chronic Disease Management Plan (CDM) in place, which your general practitioner creates to outline your healthcare needs.
Does this sound like you? If so, you could benefit from up to five Medicare-funded allied health services per year, which can include Exercise Physiology.
What Does the Service Include?
Breaking Down the Details
Here’s what you can expect from Medicare-covered Exercise Physiology services:
Session Duration: Each session is a minimum 20-minutes long.
Annual Limit: You’re eligible for up to five services per calendar year, shared among various allied health professionals.
Cost: The standard fee for a session is $70.95, with Medicare covering 85% of this amount ($60.35). Please contact Alignment Exercise Physiology for our session fees.
Knowing these details can help you plan your care and budget effectively. Isn’t it reassuring to know that professional support is accessible and affordable?
How to Access These Services
Steps to Get Started
Wondering how to get started? Here’s a simple guide:
Talk to Your GP: Schedule a visit to discuss your condition and the potential benefits of Exercise Physiology.
Develop a CDM (Chronic Disease Management Plan): If your GP permits, they will create a Chronic Disease Management (CDM) plan tailored to your health needs. This is often referred to as a GP Management Plan (GPMP).
Set Up a TCA if necessary (Team Care Arrangement): If you require input from multiple healthcare providers, your GP will set up a Team Care Arrangement (TCA) to coordinate your care with other allied health professionals.
Get a Referral: Your GP will refer you to a Medicare-registered Exercise Physiologist.
Book Your Sessions: Contact the Exercise Physiologist to schedule your Medicare-subsidised sessions. Remember, Medicare covers up to five sessions per calendar year, shared among your allied health professionals.
At Alignment Exercise Physiology in Currimundi, we’re here to help you every step of the way. How great would it be to have a team supporting you in achieving your health goals?
Why Choose Exercise Physiology?
The Benefits for Chronic Conditions
You might be wondering, why choose Exercise Physiology? Here are some compelling reasons:
Pain Management: Customised exercise programs can significantly reduce chronic pain.
Improved Mobility: Regular exercise improves our ability to move freely.
Cardiovascular Health: Exercise lowers blood pressure and improves heart health.
Diabetes Management: Physical activity helps regulate blood sugar levels.
Mental Health: Exercise boosts mood and reduces anxiety.
The benefits outlined above are only just scratching the surface. Exercise Physiology offers a natural approach to treating and managing chronic health conditions. It utilises the power of your own, natural movement.
Finding the Right Exercise Physiologist
Tips for Choosing the Best Professional
Selecting the right exercise physiologist is crucial. Here’s how to find the best fit for you:
Check Qualifications: Ensure they are Medicare-registered and have the right credentials. Our Exercise Physiologist at Alignment Exercise Physiology is an Accredited Exercise Physiologist with Exercise & Sport Science Australia (ESSA).
Read Reviews: Look for feedback from other patients to gauge their experience. Google reviews is a great place to start!
Consider Location: Choose a convenient location, like Alignment Exercise Physiology in Currimundi on the Sunshine Coast, to ensure you can attend sessions regularly.
Ask Questions: Don’t hesitate to inquire about their approach and experience with your condition.
At Alignment Exercise Physiology. we pride ourselves on delivering top-notch, evidence-informed care. Get in contact to find out how we can support you on your health journey.
Common Questions About Medicare Exercise Physiology
Addressing Your Concerns
You might have more questions about how Medicare Exercise Physiology works. Let’s tackle some common ones:
1. Can I use my Medicare benefits for telehealth sessions?
Absolutely! Telehealth has become an essential service, especially for those unable to attend in-person sessions. Medicare now covers telehealth Exercise Physiology services, ensuring you get the support you need from the comfort of your home.
2. What happens if I need more than five sessions in a year?
While Medicare covers up to five sessions per year, you might need more to achieve your health goals. In such cases, discuss additional options with your Exercise Physiologist, such as private sessions or exploring other funding sources.
3. How do I find a Medicare-registered Exercise physiologist?
You can search for Medicare-registered Exercise Physiologists through the Exercise & Sports Science Australia (ESSA) website or ask for recommendations from your GP.
Conclusion
Take the First Step Towards Better Health
Navigating Medicare benefits for Exercise Physiology doesn’t have to be daunting. With the right information and support, you can access the care you need to manage chronic conditions and improve your quality of life.
If you have any questions or are ready to get started, contact us at Alignment Exercise Physiology in Currimundi. We’re here to support you on your path to wellness.
References
Australian Government Department of Health. (n.d.). Item 10953 | Medicare Benefits Schedule. Retrieved from Medicare Benefits Schedule
By Scott Howard (Clinical Exercise Physiologist) │ 05/08/2024 │ Alignment Exercise Physiology
