Podiatry practices are businesses that bill patients for their services. Most Australian Podiatrists charge their patients on a “fee-for-service” basis (patients pay a fee each time they see their Podiatrist).

If you have ancillary health cover insurance then a percentage of the fee charged can be claimed from the health insurer. The amount Podiatrists charge depends on the length and type of consultation and any tests or procedures carried out. 

Podiatrists in Victoria may refer you for pathology tests, but these are not covered by Medicare. Your podiatrist will discuss the "out-of-pocket" expenses and offer you the option of visiting a GP for referral for the pathology tests if you prefer Medicare coverage.

Other patients, including health care card holders, may receive a reduced fee from the Podiatrist although they are under no obligation to charge a cheaper rate. Ask what fee you may have to pay when making an appointment.

Most Podiatrists will ask you to pay on the day of your consultation, sometimes you receive a discount if you do this. You can then send your paid account to your ancillary health insurer and get a rebate. Your rebate can often be paid straight into your bank account or as a cheque sent to your home.

Other Podiatrists may give you the account on your way out or send it to you in the mail: you will need to pay the account. You must pay the account in full and if you have ancillary health insurance claim your rebate from your insurance company.

Medicare Plus and Podiatry

The Medicare Plus scheme started on 1st July 2004. It allows people under an Enhanced Primary Care (EPC) Plan to gain access to Medicare rebates. The scheme currently allows for up to five (5) visits per year to an Allied Heath provider. Podiatry is one of the allied health providers who are included in this scheme.

Who will qualify?

Patients with chronic conditions or complex care needs, and are managed under and EPC plan will qualify.

Chronic conditions are those conditions which have been, or are likely to be, present for six months or more.

Complex care needs are those where a GP considers the person who8ld benefit from care provided by more than two health professionals as well as themselves.

You can get more information by talking to your GP or visiting the Medicare website http://www.medicareaustralia.gov.au

HICAPS

For patients who have ancillary health insurance you may be able to use the HICAPS payment system at your podiatrist. HICAPS is an electronic payment processing system that expedites and simplifies the system of claiming rebates from health insurance companies. Many Podiatrists in Victoria use this system. In order to claim your rebate through HICAPS you will need to bring your health insurance card to claim.

Using this system podiatrists can charge your health insurance company for the rebated part of the bill and then you pay only the amount that is remaining from the bill to the podiatrist. You can do this by cash, cheque, EFTPOS or credit in most circumstances.

Veteran Affairs

Patients holding a gold Veteran Affairs card will have all charges from the Podiatrist covered by Veteran Affairs. In order to receive treatment from a podiatrist you must have a referral (D904) from your regular GP. There may be circumstances where your podiatrist may require approval from DVA to proceed with certain treatments (supply of shoes and surgery are common reasons). The podiatrist will be responsible in most circumstances to contact DVA and organise the approval.