More health fund members will be able to access funded group exercise from April 1 thanks to a change to the schedule of services provided by accredited exercise physiologists.
The change – removal of the 60-minute time limit on group exercise sessions for a maximum eight people – will allow health insurers to cover more sessions for policy holders who may not have been ageing, returning or new to exercise, or have existing chronic conditions preventing them from being able to exercise for a full hour.
The schedule change has been endorsed by Private Healthcare Australia’s ‘General Treatment Community of Interest’, which includes representatives from all of PHA’s member funds.
The change was requested by Exercise and Sports Scienced Australia (ESSA) following feedback from their members that health insurance policy holders were experiencing barriers in accessing funded group exercise due to the session time limit.
“In cases where policy holders are ageing, returning or new to exercise, or have existing chronic conditions, it is not best practice, or evidence-based to be exercising for 60-minutes,” ESSA CEO Danielle Smith.
“By allowing accredited exercise physiologists to deliver individualised session times that are tailored to policy holders we are also opening group exercise to more policy holders. It will enable our members to tailor individualised session times that are appropriate to the policy holder’s abilities, and any pre-existing conditions.
“It’s important to note, session times will only be reduced where it is in the policy holder’s interests. Accredited exercise physiologists are ethical, skilled and tertiary trained allied health professionals who consistently work to deliver the best interventions for their clients,” she said.
All PHA member funds have updated their claiming systems and are ready to recognise the new schedule from 1 April 2025, along with HICAPS and HealthPoint Claims.
It will remain up to individual health funds to decide whether they pay benefits for the services in the schedule.
Based on the requirements of Australia’s competition laws, as well as each fund’s specific commercial imperatives, health funds will not discuss, nor jointly determine, whether they will fund a specific service. Each individual health fund reserves the right to make decisions based on its own commercial needs and customers’ best interests.
Media contact: Julia Medew, 0402 011 438 or Andrea Petrie, 0412 655 264