Mental Health Care Plan in Australia: What it Means For You


Mental health problems can be as debilitating as a physical injury for those who suffer from it. Fortunately, the Australian government has taken steps to make mental health care affordable and accessible to everyone.

Ahead, we’ll take a closer look at what you can expect from a mental health care plan, as well as how private health insurance may be able to fill some gaps.

What is a Mental Health Care Plan?

A mental health care plan can assist those suffering from a mental health disorder. After approaching your general practitioner with your concerns, you and your doctor will talk about whether or not you think a mental health care plan will help.

After that, you and your doctor will work together to develop a personalised plan that works for you. Mental health doesn’t have a one-size fits all solution, which means it’s essential to create an individualised plan for each patient.

Once you develop the plan with your doctor, he or she will prescribe you adequate treatment to help address your issue. Thanks to legislation passed in 2006, Medicare now provides accessible mental health care plans to all Australians.

How Many Sessions Does a Mental Health Care Plan Cover?

After talking to your GP and developing a plan, he or she will recommend a mental health specialist in a particular field. They will refer you to individual or group sessions, depending on which type you and your doctor feel you’ll benefit from most.

Medicare covers up to ten sessions from qualified psychologists and psychiatrists per year. After your first six, you will have to visit your GP to receive another referral for the last four sessions.

Medicare also covers any hospitalisation you might need due to mental health. You will be treated as a public patient at a public hospital if you don’t have private hospital cover.

How Much Will The Mental Health Plan Cost Me?

While you will have to cover some initial cost of your mental health care plan, you will be able to receive compensation from the Medicare system in the form of a rebate.

Your first ten sessions won’t cost you anything after the rebate – as long as your psychiatrist charges under $124.50. This is the amount Medicare will give back as a rebate, and you’ll have to cover any additional charges.

There may be some cost associated with developing a plan with your GP, but this isn’t normally the case if the GP bulk bills standard consultations.

Unfortunately, you will have to cover any additional treatment you seek out after the first ten sessions that Medicare covers. This is where hospital cover can provide further coverage to cover the gap, meaning less money out of your pocket if you require further sessions with a mental health practitioner.

How Can Private Cover Help?

Hospital cover can assist in the payment of mental health care plans; especially when they exceed Medicare’s ten-session limit.

Not everyone will be able to complete their treatment after ten sessions and therefore, could be better off seeking additional help.

It’s also possible for a doctor to craft a plan that does not entirely work for their patient. For example, sometimes, you may not find a psychologist or counsellor you personally connect with first time around. It can take time to find a specialist and treatment plan that works for you—everyone is different and there is no one approach that will lead to success for everyone.

When this happens, it’s important to have a fallback plan that allows you to visit different mental health specialists without paying out of pocket.

Depending on your policy, you may be able to seek further professional treatment for a mental health disorder. You also might be able to upgrade your plan and seek treatment within the next two months.

Unlike other conditions, the waiting period for mental health plans is relatively low. You only have to wait two months to receive private coverage – even if your fund considers it a preexisting condition.

Private health insurance can fill the gaps in treatment for mental health, beyond the 10 sessions per year that Medicare offers. With this, you’ll have access to more options when it comes to treatment.


How do I Get a Mental Health Plan?

All you have to do is visit your GP to receive a mental health care plan. They will assess your situation and design a plan that best fits your needs.

What If I Don’t Like My Psychologist?

Your GP will refer you to a licensed psychologist, but these relationships don’t always work out. It’s important to immediately let your doctor know if you’d like to see a new psychologist.

Each visit counts toward your yearly limit, even if you don’t feel as though you didn’t get anything out of your session. Try to get a new referral from your doctor as soon as possible.

Does Medicare Cover the Whole Cost?


Medicare will send you up to $124.50 for a 50+ minute session, and up to 84.80 for anything under 50 minutes. If your psychologist charges more than this, you’ll have to pay the difference.

Your doctor should be aware of these charges, and should let you know if you’ll have to pay any additional cost.

What If Ten Sessions Isn’t Enough?

Unfortunately, if you need more than ten session per year, you’ll either have to pay for additional sessions on your own or wait until the next calendar year for more.

The alternative would be to purchase an extras policy that includes psychology. If you decide to go down this path, make sure you check how many sessions are covered per year, and whether they are covered in full or part. The exact details will depend on your choice of policy and insurer.

If you’re just getting started, or are not entirely happy with your current policy, you can compare cover here.

Does Substance Abuse Count as a Mental Health Disorder?

Yes, you will be able to receive a rebate for treatment for substance abuse under the mental health care plan.

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