How Do Health Insurance Annual Limits Work?

I am with Medibank and my annual limit for Physio reached in Oct last year. When I tried to claim remaining sessions this year, Medicare is saying that I cannot claim further for last year physio service as the limit has reached.

Is it true? I have tried searching on Google but cannot find any explanation.

Comments

  • Yes there are annual limits. Resets every year.
    Go to the Medibank site search for your cover or go in store and ask the for a copy of your policy.

    • -1

      To make things simplified- I had 20 Physio sessions last year and the limit was up after 10 sessions.

      I thought you could claim within 2 years after the service so can I redeem the remaining 10 sessions of last year from this year limit?

      • +4

        Why do you think that?

      • plus 5 free from Medicare per calender year.

        • +2

          Only if you've got GP sign off, right?

      • +5

        Yes you can claim within 2 years of the service being delivered, but you will still only be paid according to the period that the service was actually delivered. So while I can claim a service that was provided in 2016 in 2017, it will still be against the limit for 2016 not the 2017 limit.

  • Also just curious as I am looking at the possibility of getting HI, does it reset at the end of each FY or at the end of your cycle (from when you joined)?

    • +1

      mine are every calendar year

    • Mine's date I joined.

    • Depends on the fund. Some is calendar year, some is financial year.

    • Medibank here, mine's calendar year.

    • HBF here, mine's calendar year as well.

  • Lol annual limit means like cap of phone plan use that year if you want it will recharge new calendar year. I personally use hell out of them.

  • also just let u know if u have good gp can recommend 5 sessions yearly bulk bill so not have to pay. But your physio need do bulk bill. Hope you have Medicare.

  • You need to ask when your policy switches to the new year. If its June 30 then you are still operating in the same year as your treatment that you had in October 2016. Sounds like the case if they say you've used up your limit already.

    As per my post above I'm with Medibank and mine resets on 1st January, no idea if that is standard for all Medibank policies though.

  • most benefit limits reset on calendar year

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