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If you’re among the 1.7 million Australians caring for someone with dementia, or you’ve been diagnosed with the condition yourself, you might be wondering whether private health insurance can help.
While there isn’t a cure for dementia, there are many treatments that can help manage the condition. In this blog we’ll explain more about using health insurance for dementia treatments.
Image credit: Shutterstock
What is dementia and how is it treated?
Dementia is a group of diseases that impacts on brain function and affects one in every 12 people over the age of 65 in Australia. Alzheimer’s disease is one of the best-known forms of dementia. Medications are usually prescribed to help control the symptoms of dementia, and some of the most common are available on the PBS (Pharmaceutical Benefits Scheme), which means they’re subsidised by the government. PBS-listed medications for dementia include cholinesterase inhibitors, memantine and risperidone.
If you’re prescribed medications for dementia, ask your doctor whether they’re available on the PBS. If they’re not, you may be able to claim back some of your costs on your private health insurance, if you have an Extras Cover policy that includes Non-PBS Medications cover. Make sure you check the conditions, and pay attention to the limits that may apply.
What dementia treatments can I claim on health insurance?
Your doctor might recommend working with allied health professionals to help you stay active, connected and independent while living with dementia. If you’re living with dementia and aged under 65, some of these costs may be covered under the NDIS. If not, and you have Extras Cover, you may be able to claim back some of those treatment costs on your health insurance.
Mental health support
If you need support for the challenging emotions that can result from living with dementia, check your Extras policy to see whether you have cover for Psychology. This will allow you to claim back some of the costs of sessions with a psychologist.
Occupational therapy
Working with an occupational therapist can help you manage your daily activities around the home. Dementia Australia provides free occupational therapy sessions under a program called ‘At Home with Dementia’ – call 1800 100 500 to find out more. If this service isn’t available to you, check your Extras Cover to see whether Occupational Therapy is covered.
Exercise and physio support
An exercise regimen can help improve your balance and strength, and help keep you active. If you have Extras Cover for Exercise Physiology you can claim back some of the costs of sessions with an accredited exercise physiologist, who can design and monitor your exercise progress. Physiotherapy cover will cover you for physio sessions to support your physical functioning, and manage pain and continence.
Speech pathology
If you’re having trouble swallowing, it can be difficult to socialise with loved ones (something that’s really important for brain health when you’re living with dementia). Working with a speech therapist can help – check your Extras Cover to see whether you’re covered for Speech Pathology.
If you already have dementia, that will be considered a pre-existing condition which means there may be a delay before you can claim for treatments on your Extras Cover policy. The length of waiting periods for pre-existing conditions varies on Extras policies, so have a chat to your insurer to find out what will apply to you. The good news is that if you switch to a health insurance policy at the same level as your existing policy, you may not have to serve any waiting periods again.
healthslips.com.au does not provide general or personalised advice. Your particular circumstances are likely to impact the accuracy, completeness and relevance of the information or results. Take this into account before making a decision and talk to an expert for financial advice.
Trudie McConnochie
Writer and Researcher
Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.
Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.
Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.
