Best health insurance plans for mental health

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Mental health and wellbeing have become less stigmatised in recent years, which is great news for everyone. But when it comes to managing our mental health needs, sometimes cost can be a prohibitive factor. That’s why finding the right health insurance for mental health services is so important.

But what exactly should you be looking for when searching for mental health cover? Your policy needs to be both cost-effective and comprehensive in its included services. Let's break down the specifics so you can take advantage of Medicare cover and what’s included in private health insurance.

Does Medicare cover mental health?

Yes, Medicare will help cover the cost of many mental health services, especially if you have a mental health care plan. However, be aware that because health professionals set their own costs, Medicare might only be able to cover a portion of your fees.

Your first port of call is to visit your doctor. When you first speak with a GP about mental health services, they will assess the level of assistance that you need. This usually involves conducting a mental health assessment, and then subsequently devising a treatment plan or referring you to a psychiatrist or another mental health professional. You may also be prescribed medications for conditions like depression or anxiety.

To best understand your situation, your GP might ask you some personal questions during the initial assessment. Because sharing concerns about your mental health can be challenging, the Healthdirect website has some tips on how you can communicate with your doctor about these sensitive matters.

In terms of costs, if your doctor bulk bills, the cost of the appointment will be covered. However, if you visit a GP that doesn't bulk bill, you'll be responsible for either the full cost or the difference between their charge and Medicare’s cover. In the case of paying the full cost, you can make a claim for the amount covered, and your doctor will assist in making a claim on your behalf.

How many mental health sessions does Medicare cover?

So long as you have a mental health treatment plan, Services Australia advises that you can claim up to 10 individual and 10 group sessions with a mental health professional every year. Initially, your doctor or psychiatrist will recommend you for a maximum of six sessions, and if further sessions are needed then they can extend the referral. Since health professionals set their own fees, you’ll likely only get a portion of the total cost covered by Medicare.

When you are setting up your mental health appointments, be sure to ask about the amount of money you will need to pay upfront, as well as how much of the cost will be covered by Medicare. If your healthcare provider bulk bills, you won't be required to make any payments. And if you have private health insurance, you might be able to claim a portion of the costs.

What is a mental health care plan?

Think of mental health care plans as a guide that will help you treat mental health challenges in phases. Usually made with your doctor, it will include the following:

  1. Mental health assessment: Your GP or psychiatrist will evaluate your individual mental health needs, taking into account factors like your symptoms, triggers and overall wellbeing.
  2. Treatment plan: Based on the initial assessment, your GP or psychiatrist will draw up a personalised treatment plan. This plan should outline the specific strategies and interventions that might be required to address your individual mental health needs.
  3. Referrals: If necessary, the plan may include referrals to other specialists like psychologists or counsellors, as well as any possible need for further assessment or therapeutic interventions.
  4. Prescriptions: In some cases, your GP or psychiatrist will prescribe medications to help manage mental health conditions. The plan should explicitly outline the details of every prescribed medication.
  5. Review and ongoing monitoring: Your mental health care plan is a dynamic document that can and should be reviewed periodically. Your doctor or psychiatrist will make adjustments based on your progress and to ensure everything is on the right path.

Having a mental health care plan also means people can get help and support with some of the associated costs through Medicare. It’s a way to ease the financial burden during a tough time and make sure everyone is working together to help improve your overall wellbeing.

How much does mental health treatment cost with and without insurance?

How long is a piece of string?

Honestly, it depends on so many different factors, from the level of support required, to the number of specialists you see, to the regularity of sessions with your GP or psychiatrist, plus medications and ongoing treatments.

The good news is that our healthcare system guarantees there are low and no-cost mental health services available for those who need them. You can also take advantage of the government’s Better Access Initiative which “gives Medicare rebates to eligible people, so they can access the mental health services they need.”

For all out-of-pocket fees and services not covered by Medicare, having private health insurance can take the brunt of the financial pain away from you. You can compare health insurance today to find a policy that includes the mental health services you want covered.

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How long are the waiting periods for mental health insurance?

The vast majority of mental health insurance policies in Australia have a two-month waiting period for psychiatric care. However, if you have pre-existing conditions, depending on what’s outlined in your insurer’s PDS, then you may be subject to waiting periods of up to 12 months.

It’s always a good idea to speak to your provider to find out what the exact waiting periods are – before signing up or switching to a new insurance policy.

Do health insurers cover in-patient psychiatric care?

The only way to be certain that you will be covered as a private patient for psychiatric treatment is to take out private health insurance.

Now, finding out which is the best health insurance for mental health services will require a bit of research on your part, but each policy’s PDS will outline what is and isn’t covered – including in-patient psychiatric care.

What should you look for in a mental health insurance policy?

While everyone has different requirements when it comes to managing their mental health needs, there are a few key things you should keep an eye out for when reviewing different policies. These include:

  • Cover for various mental health services: Make sure your preferred policy covers a wide range of mental health services, including consultations with psychologists, psychiatrists and other mental health professionals.
  • Treatment plan support: Check if the policy supports mental health treatment plans, as this will allow you to claim a certain number of sessions with mental health professionals every calendar year.
  • Flexible payments: Look for policies that offer flexible payment options, including bulk billing or partial cover of mental health service costs.
  • Medication cover: If medications are part of your mental health treatment plan, check if your policy will cover prescription medicines related to mental health conditions.

Final word

Taking some time to explore different options for mental health insurance can be extremely beneficial for your current and future health needs. Comparing online makes everything easy – just make sure your policy covers the services you need, supports treatment plans and includes cover for prescription medication (if necessary).

If in doubt, speak to your insurer and read the PDS, as this will help clarify any services that aren’t covered and any out-of-pocket costs that might affect your final decision.

Simon Jones
Written by
Simon has spent more than 15 years covering the technology and finance sectors as both a journalist and content marketer. He is fascinated by the convergence of AI and big data, and spends what little free time he can scrape together either wrangling two kids or expanding his gin collection.

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