Mental health issues affect us all – but there’s no denying mental health support and psychological treatment can be expensive. Medicare and private health insurance can alleviate the financial burden – but can you double dip to lower your out-of-pocket costs even further? Let’s find out.
SUMMARY
✅ You can claim your psychology session from either Medicare or private health insurance, but not both at the same time
✅ Medicare gives you 10 claimable psychology sessions per year, but you’ll need a referral from an appropriate medical practitioner (GP, psychiatrist or paediatrician).
✅ How much you pay after the Medicare rebate will depend on your chosen psychologist’s fee
✅ If using health insurance, your out-of-pocket costs will vary depending on your health fund provider and benefits, as well your your psychologist’s fees
If you’re navigating mental health challenges—whether that’s a specific mental illness or a broader mental health condition—you might be considering professional help. Sessions with a registered psychologist or clinical psychologist can be invaluable, but they often come with a price tag.
So, you might be wondering, “Can I use both Medicare and my private health insurance to cover the costs?” Especially when you’re worried about out-of-pocket expenses, it’s important to know your options.
Below, we’re answering everything you need to know about claiming money back on your mental health treatment, and how you can get the most bang for your buck by using both Medicare and private health insurance benefits.
Quick Answer: No Double Dipping
Here’s the quick answer: You can claim your psychology session from either Medicare or your private health fund, but not both at the same time.
Private health insurance won’t bridge the ‘gap’ between the Medicare rebate and consultation fees.
CHI TIP: Your receipt will have a code specific to either Medicare or private health, depending on which route you choose.
Using Medicare for Your Psychology Session Fees
The Australian Government created the Better Access initiative in 2006 to widen the scope of community-based mental health care. Before this change, most subsidised mental health treatment was hospital-centric. Thanks to Better Access, you can now access mental health services from the comfort of your own community.
How Many Sessions Can I Claim?
Medicare typically covers a specific number of psychology sessions per calendar year. Currently, eligible individuals can receive up to 10 single sessions, and up to 10 group allied mental health services each year.
What will it cost you?
The cost to you will vary depending on the length of the session and the fee being charged by the psychologist. If the psychologist decides to bulk bill then you will not have to pay anything. However, if the psychologist does not bulk bill then you must pay the difference between what the psychologist charges you (a fee set by the psychologist) and the Medicare rebate. This will vary and you should check this with the psychologist before commencing your treatment.
Once you max out, what do you do? That’s where private health insurance comes into play.
CHI PRO TIP: Speak with your General Practitioner and get yourself on a Mental Health Care Plan to access your 10 subsidised sessions with Medicare. Once that quota is reached, you can switch over and start claiming via your private health fund.
Claiming Via Private Health Insurance
Most private health funds in Australia offer extras cover for psychological services. These policies vary in terms of how much you can claim per year, waiting periods, and level of cover.
EXAMPLE: ahm Lifestyle Extras Cover
If you’re a single on $90,000 or less living in VIC and you took out lifestyle extras cover with ahm for $31.40 per week, here’s how they’ll help cover the costs of your mental health treatment.
For the initial consultation, ahm will cover $71 of your session fee. For subsequent consultations, they’ll pay $45.
How much ahm will cover per year depends on how long you’ve held your policy with them:
- < 5 years $250
- 5+ years $275
- 10+ years $300
- 20+ years $325
Keep in mind that not all these services are available under every type of cover, and you’ll need to check the waiting periods and annual limits to your specific policy.
Making a Claim via Medicare or Private Health
After a session, check how your service has been billed. If it falls under your GP’s mental health care plan, you’re eligible for Medicare benefits.
On the other hand, if you decide not to follow the GP’s mental health treatment plan, you can still use your private health extras cover to claim benefits.
Further Information
For more in-depth information, you can check out the Australian Department of Health website or the Australian Psychological Society. It’s also crucial to chat with your GP and mental health professional about the best approach for your mental health treatment.
Compare Mental Health Cover From Australia’s Leading Health Insurance Providers
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So, why not take a minute to compare mental health cover from Australia’s leading health insurance providers?
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