HCF GLA:D pilot program September 2024

HCF funded GLA:D program

Currently HCF are offering a fully reimbursed GLA:D program to their members who meet the eligible criteria. The program will be funded as a Chronic Disease Management Program (CDMP) and no amounts will be deducted from a member’s extra’s limits. This means there is no out-of-pocket cost and you keep all your physiotherapy extra’s limits. This will support early intervention to reduce knee and hip osteoarthritis symptoms and help prevent the need for joint replacement surgery.

Who is eligible?

You must have private health insurance with HCF and:

• have held HCF hospital cover for at least 12months;
• have hospital cover which includes joint replacement surgery for at least 2 months;
• have premiums up to date;
• meet the clinical eligibility criteria.
  

What are the clinical eligibility criteria?

• be 18 years or over
• have a diagnosis of symptomatic hip or knee osteoarthritis that is likely to require joint replacement surgery in the upcoming few years (as assessed by a physiotherapist, GP or orthopaedic surgeon)
• not have had a total or partial hip or knee joint replacement surgery;
• not have participated in the GLA:D program in the previous 2 years;
• not have participated in the Osteoarthritis Health Weight For Life program in the previous 2 years.

What does the GLA:D program involve?

The program consists of an initial consult, 12 supervised 1-hour exercise sessions over 6 weeks, 2 education sessions, and a final consult after completion of the exercise program. For further details on the GLA:D program CLICK HERE.

How do I start the HCF fully reimbursed GLA:D program?

• You will need to call HCF to see whether you are eligible under your policy.
• Once HCF approves your eligibility you will need to book an Assessment consult Item no. 500. (If you have already been assessed by your doctor or specialist to say that you are eligible then you may present this to HCF and may skip this step.)
• If you physio believes you meet clinical eligibility they will call HCF on your behalf to discuss.
• Once HCF approves the program you wil then be able to book your initial GLA:D assessment.

What to expect during the program?

Once your eligibility is confirmed with HCF, you will complete your initial assessment with one of our GLA:D trained physiotherapists and will be registered with GLA:D Australia. GLA:D Australia, will also contact you to fill out survey information to help indicate your progress in the program and aid in this ongoing research. You will complete 12 physio-supervised 60 minute exercise sessions over 6 weeks, x2 education sessions and a follow up assessment to also review your progress and then advice on what to do next.

Claiming your rebate from HCF  
As this HCF program is in a pilot stage, this service cannot be claimed on the spot through HICAPS. This means you will be required to pay upfront for each of the sessions. You will be provided with an invoice including GLA:D specific item codes that you can then claim through the HCF app, online or post.  The total amount will be reimbursed by HCF.

Can I still do GLA:D if I don’t meet the criteria?

Yes. Anyone is still eligible to participate or complete the GLA:D program. If you have private health insurance with physiotherapy extras cover you will be able to use this to claim for the program. It just means there is likely some out of pocket costs.  You may also use your Health Management Program allowance towards the program.

Are other Private Health Funds offering this?

We haven’t been informed directly of other funds offering this pilot program however we do encourage you to contact your fund and ask them.