Pain Management with Device

What is covered under Pain Management with Device?

Hospital Cover for Pain Management with Device includes hospital treatment to implant, replace or surgically manage a device needed to manage pain.

Examples include implanting:

• an infusion pump with a type of drug to help manage cancer pain

• a spinal catheter with a reservoir to help manage chronic pain
• an epidural to manage chronic pain from heart problems.

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

Some treatments you might expect to be in the Pain Management with Device clinical category are under different clinical categories. For example, treating pain that does not require a device is under Pain Management.

Which Hospital Cover tiers include Pain Management with Device?

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 with Device 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 with Device. 

Does Medicare cover Pain Management with Device?

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

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

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