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02 Feb 2014 By

Health Funds – Can I Claim?

Many health funds do provide rebates on bio-identical hormones however, some health funds do not provide these rebates.

Why is this the case?

It is important to remember that most funds are privately owned and are therefore responsible for returning profits to their shareholders. This is a simple fact. As witnessed in the recent national disasters, insurance companies often have some clause or other which enables them to somehow get out of paying on certain claims.

Health funds or medical insurance companies may also work in a similar fashion. Various reasons have been given by these health funds for not rebating bio-identical hormones (BHRT). One common misleading reason is that the BHRT medication is not TGA (Therapeutic Goods Administration) approved or not made by a recognised provider. This is misleading.

Australian Menopause Centre (AMC) doctors prescribe bio-identical hormones that appear on the national schedule of approved drugs which the TGA releases. These include Oestrogen, Progesterone and Testosterone to name a few. The doctors at AMC are fully registered with the Australian Medical Board.

If a health fund does not allow a rebate on your bio-identical hormones, then it is simply a matter that these funds have chosen not to rebate for their own reasons.  The choice is up to the individual patient whether to remain with that fund or to find another that does rebate. It is important that should you encounter problems with your fund, that you speak with us. Communication with our patients is vital and we can often be of assistance.