Pain Management

What is covered under Pain Management?

Hospital Cover for Pain Management includes hospital treatment for pain management that does not require the insertion or surgical management of a device. 

Examples include:

• steroid injections
• nerve blockers
• back pain treatment that involves radiofrequency to ‘denerve’ the problem joint.

This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS). 

Some treatments you might expect to be in the Pain Management clinical category are under other clinical categories. For example, pain management using a device (for example an infusion pump or neurostimulator) is under Pain Management with Device.

Which Hospital Cover tiers include Pain Management?

What does it mean if cover is ‘optional’?

‘Optional’ means that the Australian Government allows insurers to choose whether or not to cover the clinical category under that Hospital Cover tier.

What does ‘restricted cover’ mean? 

Restricted cover means the insurer pays only limited benefits. 

If insurers offer cover for Pain Management under Basic Hospital Cover, they can do so on a ‘restricted’ basis. If you are admitted as a private patient in a private hospital for treatments under this clinical category, you will face considerable out-of-pocket costs.

Always check with your insurer before agreeing to be treated as a private patient in a private hospital if you have restricted cover for Pain Management. 

Does Medicare cover Pain Management?

Yes. Medicare includes all treatments under the Pain Management clinical category.

If there is an MBS item number for the treatment, Medicare covers it. 

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