A Guide To Health Insurance For Psychologist Visits
Around 20% of Australians experience a mental health condition that interferes with their ability to work and live. This rises to 25% among indigenous Australians. Accessing psychological support services when you need them is key to recovering your mental health.
Approved psychological services are available through Medicare, but access is limited to ten sessions in a calendar year. If you require ongoing support, or you’re simply unable to access Medicare (for example, if you’re studying in Australia and not a resident or citizen), private health insurance does offer cover for psychology consults.
Key Points
Health insurance covering orthotics and orthopaedic shoes is typically found in top-tier extras insurance, often included within podiatry cover.
Orthotics involves the treatment of physical limitations resulting from illnesses and disabilities, including limb amputations.
The waiting period for orthotics cover is often 12 months.
Medicare may cover part of the cost or your orthotic device if it meets strict eligibility criteria.
What is psychology?
Psychology isn’t a branch of medicine like psychiatry, but a trained clinical psychologist employs different therapies to assist patients to address their psychological wellbeing. Psychological assistance can include diagnosing complex mental health disorders such as bipolar disorder, or temporary issues like work-related stress and anxiety. A psychological condition can include:
Anxiety
Depression
Phobias
Addictions
Grief
Post-natal depression
Schizophrenia
Bipolar
Obsessive-compulsive disorder
Eating disorders
Post-traumatic stress disorder (PTSD or c-PTSD)
Generalised anxiety
Relationship counselling
COMPARE & SAVE
What is a mental health care plan?
A Mental Health Care Plan (MHCP) is also called a mental health treatment plan. It’s developed for people suffering with a mental health condition. It’s usually created with your GP. Your plan identifies:
Your treatment options.
Support services available to you.
Your mental health goals, as agreed between you and your GP
. If you’re struggling with your psychological wellbeing, getting a MHCP is an important first step towards getting the help you need.
A MHCP is necessary for you to access psychological services via Medicare. You may have heard that the MHCP covers 20 free sessions, not 10. This was true during the pandemic, when Medicare lifted the number of sessions to aid the mental health of the nation during lockdown. It was reduced back down to 10 sessions in 2022.
The Australian Bureau of Statistics (ABS) National Health Survey, found more than five million Australians experience chronic mental health conditions every year. With such a huge part of the population suffering with mental illness, it is sensible for most people to consider health cover for psychology.
Chantal Kayem, Psychologist - www.chantalkayem.com.au
What if I need more than 10 sessions with my psychologist?
Extensions to an existing MHCP are rare. Usually, you’ll have to wait until the following year to access your free sessions again - unless you have a level of private health cover that includes psychology.
Psychology is included in many extras covers with around half the insurers in Australia. It’s sometimes a stand-alone service, or it’s covered under ‘allied health services’ or ‘alternative health therapies’. If it’s the latter, you may find you need to choose between one therapy and another; e.g. you can have a psychology session, or acupuncture, but not both. It’s worth checking because the funds offering psychology separately to ‘alternative therapies’ inclusions may offer you more value for your health fund dollar.
Can you use your private health insurance combined with a mental health care plan?
No, but you can use your free sessions and then continue your psychology treatment sessions through your health cover, which means you’ll be supported over a longer period of time.
What does a psychologist do?
Unlike a psychiatrist, a psychologist isn’t a medical doctor and can't prescribe medication. There are some similarities between how psychiatrists and psychologists work. Both have studied understanding how our brain works to form thoughts and habits, and how this can impact behaviour. Both offer various types of counselling and psychotherapy to their patients.
The main job of a psychologist is to assist people in developing healthy coping strategies for moving forward with their life. This encompasses working through day to day concerns, as well as more complex mental health conditions, like chronic depression.
Psychologists employ a range of therapies known as "psychotherapies." The goal is to utilise psychotherapy so that their patients may develop improved methods for managing their communication, activities, emotions, and relationships.
Psychologists pay attention to the mental state of their patient and adjust their treatment ongoing. Some of the treatments, such as hypnotherapy, may seem unusual but if your psychologist is a registered service provider, your health fund should still cover the part of the service detailed in your policy.
Some common psychotherapies include:
Cognitive behavioural therapy: Helps identify and change unhelpful behaviours.
Humanistic therapy: For learning more self-awareness to develop a more positive life outlook.
Psychoanalysis: Helps with learning about your unconscious thought patterns.
Integrative therapy: A composite therapy that includes elements of other therapy styles.
Hypnosis: Used to relax you into a state where you’re more open to helpful suggestions.
Frequently Asked Questions:
How long is the public hospital wait time for psychology services?
The waiting time for accessing psychology treatment via Medicare can be over 12 months, with 1 in 3 practitioners closing their books to new patients to new patients over the past 2 years.^
How much do psychologist visits cost?
The Australian Psychological Association recommended rate for Clinical Psychology in 2022 – 2023 is:
$280 for a 50-minute psychology session.
$406 for an 80-minute session (also the initial assessment fee).
Does Medicare pay for psychologists?
You claim up to 10 psychology sessions per year through Medicare for free. You're required to visit a GP for a referral. This can assist you with the cost of ongoing psychological care.
Does private health cover psychologist visits?
Yes, counselling and psychology is covered by some extras insurance policies.
Each fund is different, so contact your fund before your psychology appointment and confirm what they’ll pay for - and what they won’t.
IMPORTANT NOTE: You cannot use your health cover benefits at the same time as your Medicare MHCP. In fact, some funds may insist that you access your MHCP first before claiming on any of your health fund benefits for psychology.
How long are waiting periods for psychology visits?
Psychologist services falls under extras cover. The waiting period is usually 2 months. If you’re consulting your psychologist regarding post-natal depression however, check your policy. Claims for pregnancy cover have longer waiting periods (usually 12 months), so ensure you can claim your sessions sooner under your extras cover if you need to - or consider another fund.
How do I get covered for psychology?
Visit your GP: Your GP will create a Mental Health Care Plan (MHCP) if they deem psychology is necessary.
Get your referral - you’ll need this to claim your Medicare rebate.
Make an appointment with your psychologist: Your initial treatment includes up to 6 sessions.
IMPORTANT NOTE: Request their fee schedule up front.
Visit your GP again: This is your cue to check in and ask for four more sessions if you feel you need them, or to request another referral if your initial psychologist isn’t working out.
With your MHCP, Medicare rebates you $84.80 per 1 x 50+ minute session with a general psychologist, and $124.50 for a session with a clinical psychologist.
If your psychologist’s session fees are higher than this, you’ll have to pay the difference.
What psychology support is available through private health insurance?
Most insurers offer psychology cover through your extras policies. This is the part of your health cover that insures you for non-hospital related treatments, like dental care and alternative therapies (e.g. acupuncture). Your health fund will have a set dollar amount that you’re allowed to claim for each extras treatment throughout the year. Your psychology sessions will work the same way.
There’s no need to visit your GP beforehand because you don't need a referral for seeing a psychologist via your private health cover. You don't need your MHCP either.
What should you be aware of when using private psychology cover?
Be aware of your benefit limits.
There will be a maximum amount you’re able to claim each calendar year. There’s also wide variation in the level of cover for this service, so check your policy details carefully. For example, benefit limits for your first visit can be as little as $20 or more than $200. Benefits for the second and subsequent visits are usually smaller, as the session fees are less as well. Some health funds have separate limits, like a $300 limit for remedial massage and a $500 cap for psychology. Other funds offer combined limits; e.g. $800 limit for all extras that you can apply to whichever services you want. Policies with combined limits are often the better choice. Look for policies that pay a percentage of the bill, often ranging from 50% to 80% of your cost. This can work out better for you depending on what your psychologist charges. Unlike Medicare rebates which are fixed, the rebates provided by private health funds differ depending on the fund you are with and your level of private health cover.
For Example: The average cost of a psychology session is around $280.#
A combined extras cover provides a rebate of 80% of the cost of psychological therapy or psychology services up to the annual limit of about $1800.**
That’s about 8 sessions.
You’ll be out of pocket by about $55 per session.
Ask about in-network and out-of-network providers as well.
Your extras cover can pay for a percentage of each therapy session, while you pay the rest. Some insurers will cover a higher percentage of your session fees if you use a psychologist in their network (i.e., your psychologist is in-network for your health fund). The savings may or may not be worth it depending on the size of your fund’s provider network, but it’s something to consider when looking at the value you get from your health fund.
When comparing health insurance policies you'll want one that offers the best value, and there's more to value than just price. Keep an eye out for how insurers treat the following:
Waiting periods: Many extras policies have short waiting periods for psychology. For a brand new policy, you'll probably need to wait before claiming for your psychology treatments. You might be able to find a special offer that waives waiting periods for some treatments including psychology.
Can overseas visitors get psychology cover?
If you’re an overseas visitor, such as a student or resident worker, you can get covered for psychology, but you may have to jump through a few hoops:
Reciprocal Health Care Agreements: If you’re from a country with an agreement to provide healthcare to each others’ citizens (like New Zealand), you can get the same free 10 psychology sessions per year Australians can access via Medicare.
You’ll need to visit your GP and provide proof that you require counselling for an ongoing mental health issue that has caused problems in your life, and is causing some currently. Supporting records from your place of birth can assist in this.
Via your private health cover: Private health insurance is available to long-staying visitors. Some overseas visitors are required to take out private health cover before their visa is even granted, so they land here with their cover in place. The two policies you can access are:
Overseas Visitors Health Cover for workers (OVHC)
Overseas Student Health Cover for students (OSHC).
Both have extras options available to be purchased. Not all OVHC and OSHC extras cover include psychology services, so it’s worth checking before you buy if you will require a psychologist during your stay in Australia.
How do I claim for psychological treatment?
Depending on who you’re insured with, you can claim by:
Swiping your health insurance card when paying.
Using your health fund’s mobile app.
Filling out a claims form and faxing, emailing or posting it to your insurer.
Visiting your health fund's office in person with your claims form.
Getting treated by a provider affiliated with your health fund who will lodge your claim directly.
Conclusion:
Whether dealing with diagnosed long-term conditions like depression or anxiety, or facing shorter-term challenges such as relationship breakdown or workplace stress, psychology services offer a structured approach to learning how we might manage these issues. Therapeutic interventions can help you gain insight into your thoughts, emotions, and behaviour so you can develop healthier coping strategies and real-life resilience. Psychology services contribute to early intervention and prevention of mental health breakdowns and psychological collapse. By seeking assistance when early signs of distress emerge, you’ll receive timely assistance to mitigate your condition, or even alleviate it entirely. This proactive approach not only helps in addressing current concerns but can create a foundation for your long-term psychological well-being. This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.
