If you’ve been putting off that physio appointment, the end of the year is a good time to book in. Both your Medicare allied health visits and your private health extras are tied to the calendar year, and unused benefits don’t carry over.

Medicare: the Chronic Condition Management Plan

If you have a condition that has lasted, or is likely to last, six months or longer, such as osteoarthritis, rheumatoid arthritis or chronic back pain, your GP may be able to put a plan in place that gives you Medicare-subsidised physio visits.

What’s changed: The older GP Management Plan and Team Care Arrangements were replaced on 1 July 2025 by a single plan, the GP Chronic Condition Management Plan. You may still hear people call it a “CDM plan” or “care plan”. It’s the same idea with simpler paperwork.

What you get: Up to 5 Medicare-subsidised allied health visits per calendar year. These can be split across different providers, such as physio, a podiatrist or an exercise physiologist, as long as the services support your chronic condition. You can attend more than 5 sessions, but anything beyond 5 won’t attract a Medicare rebate.

Who decides: Your GP decides whether your condition would benefit from allied health services. It’s not automatic, so you’ll need to book a dedicated appointment and ask whether a plan is right for you.

Good to know

• The plan comes first, so book the GP before you book with us.
• You can check how many visits you have left through your myGov account.
• Your visits reset at the start of each new calendar year. If your plan is current, any unused visits from this year are lost on 31 December.
• Your Medicare rebate does not cover the full fee. Medicare appointments attract an out of pocket expense. Full payment is required at your appointment and we will submit your claim to Medicare on your behalf. If accepted, Medicare will deposit your rebate directly into your registered bank account. The current Medicare rebate is $63.40.

Private health extras

Extras cover pays back a percentage of what you spend on services such as physio, up to an annual limit. Most funds reset on 1 January, so anything unused is lost, though some reset on 1 July or on the anniversary of when you joined. Check your fund’s reset date and your remaining physio limit in its app or member portal.

Some policies also have a per-service sub-limit. Once you hit it, you can’t claim more for that service until the reset, even if you have other limits left.

Can I use both?

No, you can’t claim the same visit from both Medicare and your health fund. A simple approach:

1. If you have a current plan, use your five Medicare visits for your chronic condition first.
2. Use your extras for any further visits, or for treatment that isn’t part of your plan.
3. Check your fund’s limits so you don’t leave money unclaimed.

Plan ahead for December

Appointments fill quickly in the last few weeks of the year. If you’d like to use your Medicare visits or extras before they reset:

• Book your GP appointment now to ask about a plan.
• Book your physio visits early. Call us on 9447 6152, or book online here.
• Bring your plan or referral to your first visit.

Not sure what applies to you? Call us on 9447 6152 and our team can talk you through it.

This post is general information only. Eligibility depends on your individual circumstances, your GP’s assessment and your health fund’s policy.