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What should you know about physiotherapy cover?

Unlike many diseases that can be prevented by vaccinations or maintaining good personal hygiene, physical pain and injuries are arguably unavoidable, and something that most of you have probably suffered from at some stage in your life. From incorrect sitting posture, overuse of certain muscles, to strains and tears and workplace accidents, we are all potentially vulnerable and the only difference seems to be pain intensity. This is where physiotherapy comes in handy as it can not only reduce chronic pain and discomfort in your daily lives, but can also help you regain, as well as maintain movement and physical function in the long run.

However, since physiotherapy usually involves a lot of reassessments, multiple therapy sessions, exercise programs with hourly charges, and advanced therapy systems such as laser, ultrasound, and shockwave devices, treatment can become very expensive. Thus, it is imperative that you have the right insurance plan in place to cover all relevant expenses should you require physiotherapy in future.

This week, Pacific Prime Hong Kong will take a closer look at the nature of physiotherapy, its scope of coverage, the insurance claim process, and any major exclusions to look out for.

Individual Health Insurance Plans

What is physiotherapy?

Physiotherapy is a type of treatment that aims to help patients reduce pain and improve their physical abilities. Physiotherapists can work on preventative health or post-surgery rehabilitation to aid restoration in patients. The Physiotherapists Board oversees the work of physios in Hong Kong, of which many are available all around the SAR. Some of the common conditions treated by physiotherapists include:

  • Back and neck pain
  • Shoulder pain
  • Muscle and joint pain
  • Movement disorders
  • Postural ailments
  • Sport injuries
  • Post-operative rehabilitation such as joint replacement or knee reconstruction
  • Certain chronic illnesses
  • And more

What is included under physiotherapy cover?

Depending on your policy details, physiotherapy cover may be included as a standard benefit, or as an additional, standalone benefit.

As mentioned above, since physiotherapy can be quite expensive, most insurance policies will include a limit on how much you can claim for such treatment, which comes either in a monetary amount (such as $1,000 per year), or in the number of therapy sessions.

The scope of coverage depends on your policy details and the price of your plan. Physio treatments may include the following:

  • Functional Exercise
  • Massage
  • Taping
  • Heat
  • Dry Needling
  • Postural Correction
  • Muscle strength and conditioning training
  • Manipulation
  • Electrotherapy
  • Mobilization
  • And more

Click here for more information about occupational health treatments and specialists specifically.

What is the insurance claim process?

As a general rule of thumb, accidental injuries are usually covered by most forms of health insurance as long as they develop after the policy takes effect, and are not excluded from the policy. Nevertheless, it still pays to double check your policy coverage to ascertain exactly whether physiotherapy is covered, and if yes, how.

In Hong Kong, normally you would need to consult a general practitioner and obtain a referral letter before you consult a physiotherapist and lodge claims for your expenses to the insurer. As with other forms of insurance, you should make sure that you have submitted all the materials required including the referral letter and the receipt. It’s also important to notify your insurer if you require multiple visits to the physiotherapist.

What are the major exclusions to look out for?

Just like other health insurance solutions, the physiotherapy benefit also has its exclusion items including:

Pre-existing conditions

Pre-existing conditions are medical conditions that develop before the policyholder’s term starts to take effect. Health insurance policies also would not cover congenital deformities or anomalies.

Locations outside of your region of coverage

If you have a local health insurance plan, any treatments received outside of Hong Kong will likely be ineligible for coverage.

Occupation-related injuries

When the insured is engaged in duty for the following occupations:

  • Occupations that involve the use of light machinery or engines, such as electrician, catering worker, and private car driver.
  • Occupations that involve the use of heavy machinery and require a high degree of physical exertion or working in a hazardous working environment, such as delivery worker, road worker, and interior decorator.
  • Occupations that are in duty with any armed force of any country or international authority.
  • Other occupations including fireman, ship crew, aerial worker, racing driver, China-Hong Kong cross-border driver, worker at height, and more.

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Seek advice from an established insurance specialist

While the policy terms of physiotherapy cover seem to be relatively easy to digest and straightforward, it is still worth the effort to seek professional advice in structuring your insurance plan. One important thing to look out for is to see if the insured items and relevant limits are enough to cover your actual needs and potential medical expenses. For instance, while a $100,000 claim limit on accidental outpatient medical expenses may seem high, the claim limit for physiotherapy treatment such as laser or shockwave therapy could be $1,000 only.

Drawing upon close relationships with multiple major insurers around the world, an established insurance broker like Pacific Prime Hong Kong can serve as an additional layer of support to help you make a more informed insurance decision. Contact us today for impartial insurance advice, an obligation-free quote, and a plan comparison!


Content Creator at Pacific Prime Hong Kong
Anthony Chan is a content writer at Pacific Prime. He’s responsible for writing, translating, and editing articles, guides, infographics, leaflets, as well as other resources for Pacific Prime and Kwiksure.

When he’s not working, he’s usually on the hunt for great restaurants, playing badminton, and writing screenplays.