Need to know
- You can access up to 20 Medicare-subsidised mental health treatment sessions per calendar year
- If you need to use in-hospital psychiatric care but are not covered, you can upgrade your health insurance without a waiting period
- COVID-19 restrictions can cause or worsen mental health issues
As well as causing respiratory and other physical health problems, COVID-19 can also affect mental health. Extended lockdowns, self-isolation or loss of employment can cause or worsen mental health issues, such as anxiety or depression.
In a normal year, one in five Australians experience anxiety, depression and other mental health conditions preventing them and their families from going about their normal lives.
Young people (15–24 years old) are among the most affected, and suicide is the biggest killer of young Australians, even before car accidents.
It’s therefore crucial to be able to access mental health services when you need them. Up to 20 Medicare-subsidised counselling sessions are now available through your GP, and if you have extras health insurance, it can cover visits with a psychologist.
Public hospital psychiatric care services are often overstretched, but if you have private health insurance, it can cover you for care in a private hospital.
Ask your doctor about mental health treatment
If you or your loved ones experience mental health problems, it's a good idea to visit your GP. Your GP can assess and diagnose conditions, and work with you to create a mental health treatment plan. The plan includes treatment options and goals, and is kept private between you and your GP.
Through the plan, you're eligible for Medicare-subsidised visits to a mental health professional. To begin with, your GP will prescribe six sessions and you can get more if you need them. The total number of sessions you can access through Medicare has increased from 10 to 20 per calendar year. The 10 extra sessions will be available until 30 June 2022.
These sessions can include appointments with:
- a psychiatrist
- a psychologist
- a counsellor
- a social worker
- an occupational therapist.
Appointments can be face to face or via video, phone or online.
Depending on the practitioner you visit, you may get bulk billed or receive a rebate towards the cost. To find a practitioner, visit beyondblue.org.au.
Does health insurance cover mental health?
There are two types of health insurance:
- extras insurance offers cover for services out of hospital, such as sessions with a psychologist
- hospital insurance covers services in a hospital – all policies cover in-hospital psychiatry in a public hospital, while Gold policies cover this in a private hospital.
Psychologist visits covered by extras health insurance
We looked at standalone extras policies in NSW and found that more than half of them covered psychologist visits or counselling sessions.
There is great variation in the level of cover for this service, so if you need cover for this, look at your policy details closely. For example, the benefits for the first visit range from $20 up to $237, with an average benefit of $75. Benefits for the second and subsequent visits are usually smaller, with an average benefit of $63.
Some policies instead pay a percentage of the bill, ranging from 50–80% of your cost, which can work out better for you depending on what your psychologist charges.
Next to what benefit you get for each visit, you also need to check the maximum annual benefit, which ranges from $200–1300. It's important to check if the annual limit is just for the service or combined with a range of services.
For example, the policy with the highest limit ($1300) combines it with the limit for occupational therapy, eye therapy (orthoptics), exercise physiology, dietary advice, birth and postnatal classes, hearing services (audiology), speech therapy and podiatry. So if you use any of these services, you will have less to use for psychology.
Bupa and Medibank cover for mental health compared
We looked at the most expensive standalone extras policies from Bupa and Medibank. Both funds have a number of other extras policies. Use our online tool to compare health insurance policies from all 36 health funds.
|Fund & policy||Premium||Limit/year||1st visit||Other visits|
|Medibank Top extras 90||
|Bupa Top extras 90||
Source: data.gov.au, August 2021
*NSW, Single per month, before health insurance rebate.
Better access to in-hospital care through health insurance
When it comes to in-hospital psychiatric care, the public system is often stretched thin. Health insurance reforms in 2019 created better access to these services through your health insurance.
Private hospital cover for in-hospital psychiatric services is normally only available with an expensive Gold policy. Since the reforms, as long as you have any hospital cover (even a Basic cover level, which hardly covers anything at all), you can upgrade to a policy that covers in-hospital psychiatric services without serving a waiting period, should you need this cover unexpectedly.
- If your policy does not cover in-hospital psychiatric care, you can upgrade to a policy that covers it without a waiting period once in your lifetime (you need to have already held a hospital insurance policy for at least two months). Check out the cheapest basic policies we've found.
- You can even do this when you've already been admitted to hospital – if you upgrade within five business days after entering hospital, you'll be covered for your full hospital stay.
If you think you need cover for in-hospital psychiatric services, it's a good idea to upgrade as soon as you can, as it's not always practical to upgrade once you've been admitted to hospital.
"We have some concerns that five days may not be enough time to make arrangements from the date of admission," says Dr Kym Jenkins, President of the Royal Australian and New Zealand College of Psychiatrists.
Private hospitals may ask for payment in advance which could be a financial burden. It could also be complex to find the right policy to upgrade to and may mean switching health funds if your health insurer does not offer a suitable policy or does not have an agreement with the hospital you're admitted to.
It can also take some time to find the right policy, as you'll want to make sure it covers all of your needs. To find the best policy, compare health insurance with our easy tool and weigh up your options.
Mental health cover checklist – hospital insurance
If this cover is important to you, check the policy's cover carefully for the following options.
- In-patient psychiatric care in a public and private hospital. Is there an annual maximum number of admissions or days covered in hospital? And does it cover readmission to hospital within days of a previous hospital stay?
- Day programs in private hospitals. Is there any limitation on how many hours per visit are covered?
- Outreach nursing. Can you get cover for a day program and outreach nursing at the same time?
- Specific treatments, such as electroconvulsive therapy, to treat severe depression.
- For all public and private hospitals, not only a selection. Different private hospitals specialise in the treatment of different mental health conditions, and you want to be able to access the best one for your needs.
If you have a complaint about your health fund, contact the Private Health Insurance Ombudsman on 1800 640 695.
For immediate assistance, contact 24/7: