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Health insurance and mental health
Private health insurance can help with the costs of mental health support in a few key ways, ranging from psychological treatment to psychiatric care. Medicare can help too.
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How health insurance can offer support for your mental health
Private health insurance can cover you for a range of mental health services. Extras only policies tend to be cheaper while hospital policies are more pricey. We've broken it down below:
How an extras only policy covers mental health
Most extras only health insurance policies include cover for psychology treatments. These services are typically appealing to those who are struggling with any of the following:
Anxiety
Depression
Schizophrenia
Bipolar
OCD
Eating disorders
PTSD
Everyday stress
Additions
Phobias
Everyday stress
Grief
Postnatal depression
And much more.
How does an extras policy work for mental health?
Every extras policy is split into categories. The names may vary by provider but it usually follows something like: dental, optical, psychology, etc. Under the psychology category, this is where you'll find the specifics of what's covered in your policy and the benefit limits.
Let's say for example, your provider's psychology category includes the following treatments: psychology sessions, counselling sessions, hypnotherapy and general health improvement. The annual benefit limit for this category might be $200. This means you can claim up to $200 across all the benefits listed under that category. You may choose to spend the whole $200 on psychology sessions or you may choose to claim $100 for psychology, $50 for hypnotherapy and the remaining $50 for general health improvements. The choice is yours.
It's important to note that the full benefit limit may not be able to be redeemed in one go. So even if you have $200 worth of cover, you may only be able to claim $50 per appointment. This means that you will likely still have out of pocket expenses and should be prepared for this.
Waiting periods
When accessing the psychology benefits on your extras policy, waiting periods may apply. This varies from provider to provider and some even waive the waiting periods altogether.
How a hospital policy covers mental health
Basic, bronze and silver hospital policies cover psychiatric services on a restricted basis. This means some but not all services are covered. A gold hospital policy is the only level of cover to fully cover psychiatric care.
It's important to note that you may still have out of pocket expenses, even if you have health insurance. The limits that apply to your policy will be disclosed in your product disclosure statement (PDS). Read this thoroughly to understand what costs you need to be prepared for.
What psychiatric services does hospital health insurance cover?
Hospital insurance covers inpatient care. This means you're covered when you check into a mental health facility to be in the direct care of medical professionals. A policy can pay for your hospital accommodation and a portion of your medical fees. It can cover the treatment of the following:
Psychiatric disorders e.g. schizophrenia
Substance abuse disorders e.g. drug, alcohol and gambling addictions
Personality disorders e.g. paranoia
Eating disorders e.g. anorexia
Personality disorders, e.g. paranoia
Mood disorders e.g. bipolar, depression and postpartum depression
Anxiety illnesses e.g. obsessive compulsive disorder (OCD)
Trauma e.g. post-traumatic stress disorder (PTSD)
Waiting periods for mental health services and hospital treatment
You'll usually have to serve a 2-month waiting period for psychiatric services and rehabilitation, even if your condition is pre-existing. The only exception here is if you currently hold one level of hospital cover (for example, silver) and want to upgrade your policy to gold. Even though you've technically changed policies, you shouldn't have to wait out another 2 months before you can access the mental health treatments or care. Be aware though; you can only do this once in your lifetime.
How Medicare can help those with mental illness
Medicare offers cover for up to 10 sessions with a psychologist or psychiatrist. Unfortunately, it's unlikely that the Medicare benefit amount will cover the whole cost of the session. This means there are still some out of pocket expenses, however, it can go a long way to help make them more affordable.
To get access to this, you will need to get in touch with your GP to organise for a mental health care plan. From there, you will be referred to a psychologist or psychiatrist based on your needs. This referral will give you all the right documentation you need to claim the cost (or part thereof) back on Medicare. If your GP bulk bills then it's likely the initial appointment to get the mental health care plan will be covered completely by Medicare.
Free support via Australian organisations
There are several free and confidential resources available for those who are concerned about their mental health and want access to free help or support.
Lifeline. (13 11 14) A national charity providing 24-hour crisis support and suicide prevention services.
Australian Government: AIHW MHSA. The Australian Government website provides information on mental health services in Australia.
Beyondblue. Help for depression and anxiety related matters.
Black Dog Institute. Provides resources and support if you're suffering from depression, anxiety and more.
Each month we analyse over 10,000 hospital insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare hospital cover a bit faster.
Before we start scoring, we need to make sure we're comparing like-for-like. Just as it doesn't make sense to compare a bicycle with a Ferrari, it doesn't make sense to compare basic hospital policies to top-tier Gold policies. Each policy is given a price score and feature score. These are then combined to determine each policies's Finder Score.
All prices are based on a single individual with less than $97,000 income and living in Sydney.
FAQs
If you have an extras policy then it's likely you are covered for psychology services. To find out, look at your product disclosure statement to see if it's included in your level of cover and what the benefit limits are. If you can't locate your product disclosure statement, get in touch with your insurer and they should be able to point you in the right direction.
To an extent, yes. Medicare can help with the cost of seeing a psychologist or psychiatrist. You'll need to have a mental health care plan to access this, which can be organised via your GP.
If you have a gold hospital policy then you are covered for inpatient psychiatric services. If you have a silver, bronze or basic policy then you are covered on a restricted basis. If you don't have health insurance at all then you may be able to get help in a public hospital but wait times are typically very long and you may not be able to access the services you need immediately.
Under a hospital policy, no. Under an extras policy though, you may be covered depending on what kind of outpatient care you need. An extras policy can support you for outpatient mental health services like psychology.
Only if you have hospital cover and only if the treatment is taking place in a hospital.
Yes, but it's only 2 months, even if you have a pre-existing condition. The Mental Health waiver also allows you to upgrade your policy without serving the usual 2-month waiting period to access in-hospital psychiatric services.
Peta Taylor is a publisher at Finder, working across all of insurance. She's been analysing product disclosure statements and publishing articles for over 2 years. Peta is passionate about demystifying complex insurance products to help users make well educated decisions with confidence. Peta is part of Finder's insurance awards team and works alongside editorial and insights experts to bring users the best insurance products every year. See full bio
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