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Does Private Health Insurance Cover Psychology?
Does Private Health Insurance Cover Psychology?
Written by
Madeline Pettet
Edited by
Andrew Kemp
Reviewed by
Andres GutierrezCompare Health Insurance Policies
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Long story short
Extras health insurance can include cover for psychology services
Meanwhile, some psychiatry services are covered by hospital policies.
Medicare can help pay for your psychology help
But you’ll need to meet eligibility requirements, like having a Mental Health Treatment Plan. You might also have gap payments to cover.
How much you get back from your private health insurer depends on your policy
Look at a policy’s benefit amounts or percentages, along with any limits and waiting periods when you compare extras cover.
Does private health insurance cover psychology?
Psychology services, including counselling, are included on some extras health insurance policies.
Types of psychological services covered by private health insurance
If your extras policy covers psychology, this could include individual and group consultations, as well as psychological assessments. Your health insurance might also cover seeing an accredited mental health social worker and using digital mental health interventions, like completing online cognitive behavioural therapy (CBT).
Although also an important mental health support, psychiatric services are treated differently by health insurance. You’ll find cover for psychiatric help, like ongoing private hospital care, on hospital cover policies rather than your extras.
Keep in mind, too, that private health insurance doesn’t cover psychiatrist appointments outside of hospital. These are treated like other specialist appointments, and you can only get money back through Medicare.
Does Medicare cover psychology?
There are a few Medicare initiatives to help cover the costs of psychological treatments.
Mental Health Treatment Plan
As part of the Better Access Initiative, your GP or psychiatrist can put together a mental health care plan for you. With this plan, Medicare can cover up to 10 individual and 10 group psychology sessions for you each calendar year. It includes face-to-face and telehealth sessions, by the way.
You also don’t necessarily have to see a clinical psychologist as part this mental health support. You might be referred to a GP with a special interest in mental health, a psychiatrist, a social worker, or even an occupational therapist.
Chronic Disease Management Plan
With a Chronic Disease Management Plan, you could get Medicare rebates for up to five visits with a psychologist. This plan is for people who need help adjusting to and managing a chronic or complex illness.
Keep in mind that your five-visit limit is shared with any health care professionals also listed on your plan, like a physiotherapist or occupational therapist. For instance, you might use two of your covered sessions to see a psychologist to talk about how you’re emotionally handling your diagnosis. The other three could go towards seeing a physio to work on strength exercises to help manage your condition and improve your physical health.
Other eligibility criteria
If you’re feeling concerned about a pregnancy now or one within the past 12 months, you might also be able to get Medicare rebates on psychology sessions. The same goes for First Nations or Torres Strait Islander people using follow-up allied health services.
Even if you’re eligible for a Medicare rebate, you might still have out-of-pocket costs. There might be a gap between what the mental health professional charges and the Medicare rebate.
How much can I claim on health insurance for psychology?
Psychology extras benefits can range from around $20 to over $160 for an initial session, depending on your policy and level of cover. Your benefit might be a set dollar figure or a percentage of the session fee. There’ll usually be a claim limit, too. Once you hit that ceiling, you won’t be able to claim any more psychology services until your limit resets (this is usually annually).
Importantly, you’ll need to see a provider that’s recognised by your health fund.
You’ll also need to serve any relevant waiting periods before you can start claiming.
Benefit amounts, limits, waiting periods, and which providers you can see are all worth considering when you’re comparing extras cover. For instance, you might prefer a policy where psychology services have their own limit, rather than one shared with other eligible extras.
Helpful tip
One of the advantages of using your health insurance to cover psychology appointments is you don’t need to see your GP first for a referral. If you’re finding it hard to cope or are dealing with difficult emotions, removing that extra step can make it easier to get the support that’s right for you.
Andres Gutierrez
General Manager – Health
Frequently asked questions
How do I make a claim for psychology on my health insurance?
You can claim psychology services by swiping your health fund membership card when it comes time to pay for your appointment. Alternatively, you can pay in full and use the receipt to make a claim online or through your health insurer’s app.
Can I claim a psychology session on both Medicare and private health insurance?
You can’t double dip and claim both a Medicare and private health insurance rebate for the same psychology session.
If you want the best of both worlds, you could use your 10 sessions in your Medicare mental health care plan for the calendar year, and then claim any other sessions on your extras cover. Your policy might even require you to do this before you can start claiming on your cover.
Are psychology sessions available via telehealth?
Your policy might let you claim on telehealth psychology sessions (e.g. over the phone or a video call), but those sessions might need to meet certain requirements, like being at least 30 minutes long.
Where can I find and compare health insurance
If comparing health insurance feels like the straw that breaks the camel’s back (or makes the camel grind their teeth at night), iSelect is here to help. We make it easy to quickly compare a range of health insurance policies from different health insurers. Just call one of our Australia-based health comparison experts on 1800 784 772 or use our online comparison tool.
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