Health Fund Advice

Word of caution regarding health fund claims – check if the nutritionist/dietitian/specialist is registered with your health fund and what category e.g Dietitian. If they are an integrative GP, a small portion of their fee will be covered by Medicare (but if covered by Medicare then a health fund will not cover).

Sometimes funds require specific wording on a receipt/invoice such as “Individual Nutrition/Diet Consultation” but won’t pay up on words like “Health Assessment” or “Health Diagnostic/Test. As far as I know, few funds will cover tests that are not covered by Medicate, which unfortunately are diagnostics often used by integrative specialists. Call your fund and find out exactly what they do and don’t pay up on and advise your practitioner in advance to see if they are happy to specifically word your invoice.

If you have private script rebates, compounded scripts are often covered but ask for the script to be named something like Bioceutical or Methylation Formula and NOT Vitamin Capsules! If you can avoid the printing of the ingredients on the official pharmacy receipt, ask if they will not include the list of vitamin ingredients.

You may also like to ring your health fund to check that the compounding pharmacy you intend to use is registered with them. There are many little loopholes that health funds use to dodge paying claims that are not ‘straight forward’. Interrogate them (most calls are recorded) and you may need to be prepared to challenge a claim not paid.

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