Health insurance for psychiatric care

Psychiatric services include treatment for conditions like mood and personality disorders, eating disorders, addiction and other mental health issues. Many hospitals have their own psychiatric wards, while there are also a number of dedicated private psychiatric hospitals and private clinics that specialise in particular disorders.

In Australia, health funds are legally required to pay certain minimum benefits for psychiatric care in hospitals and cannot exclude it entirely. Generally, this minimum or restricted benefit will apply to mid-

Mental health issues are serious and can be costly, which is why Australian health funds are legally obligated to offer cover for treatment.

Compare health insurance that includes psychiatric treatment

As an example, below you'll find options from Finder partners that include in-patient psychiatric treatment in a private hospital. They come with a 2 month waiting period - but you may be able to access earlier if eligible for the Mental Health Waiver. Your chosen health fund can help you with this.

Provider	Policy	Treatments included	Excess	Price	Apply
	Hospital Gold	Depression, anxiety, shyness, panic, health anxiety and obsessive-compulsive disorder (OCD).	$500	$164.05	Go to Site
	Top Hospital Gold	Psychiatric, mental, addiction or behavioural disorders.	$750	$168.90
	Gold Hospital	Psychiatric, mental, addiction or behavioural disorders.	$500	$172.14	Go to Site

*Quotes are based on single individual with less than $90,000 income and living in Sydney.

Which Australian health funds offer cover?

• finder.com.au health funds
• Other health funds

Health fund	Hospital policies that cover psychiatric services	Waiting periods
	Core Hospital $750 Excess Core Hospital $500 Excess Base Hospital $750 Excess Base Hospital $500 Excess Base Hospital (Co-pay) $500 Excess Entry Hospital $500 Excess	2 months
	Top Hospital Gold Deluxe Silver Plus Classic Silver Plus Starter Silver Core Bronze Plus Lite Bronze Plus Starter Bronze Essentials Basic Plus Starter Basic	2 months
	Hospital Gold Hospital Silver Plus Hospital Silver Hospital Bronze Plus	2 months
	Silver Advantage Hospital Plus Silver Hospital Bronze Hospital Plus Basic Essential Hospital Plus	2 months
	Gold Top Hospital Silver Hospital Plus Bronze Hospital Basic Hospital	2 months
	Gold Hospital Silver Plus Hospital Bronze Plus Hospital Bronze Hospital Basic Hospital	2 months

Health fund	Hospital policies that cover psychiatric services	Waiting periods
Australian Unity	Ultimate Gold Advanced Hospital Intermediate Hospital Standard Hospital Simple Hospital	2 months
Bupa	Top Hospital with Pregnancy Top Hospital no Pregnancy Mid Hospital Lite Hospital	2 months
CUA Health	Premium Hospital Premium Hospital - Non-obstetrics Standard Hospital Accidental Only Hospital Basic Plus Hospital	2 months
GMF	Complete Hospital Cover Mid Hospital Cover Lite Hospital Cover	2 months
GMHBA	Gold Ultimate Hospital Silver Plus Classic Hospital Silver Plus Premium Hospital Silver Core Hospital Silver Plus Hospital Bronze Plus Hospital Bronze Essential Hospital Basic Plus Hospital	2 months
HBF	Gold Hospital Silver Hospital Plus Silver Hospital Bronze Hospital Plus Basic Hospital Plus	2 months
Health Care Insurance	Gold Hospital Bronze hospital	2 months
hif	Gold Star Hospital Silver Plus Silver Plus Hospital Silver Bronze Basic Plus	2 months
Latrobe Health Services	Gold Star Hospital Gold Hospital co-payment options Gold Hospital Reducing Excess Gold Hospital Excess options SilverPlus Hospital $750 excess Silver Hospital $750 excess BronzePlus Hospital $750 excess Healthy Start Basic Hospital Package Basic Public Hospital	2 months
Medibank	Medibank Gold Complete Medibank Silver Plus Security Medibank Silver Plus Assured Medibank Silver Everyday Medibank Bronze Plus Progress Medibank Bronze Everyday Medibank Basic Plus Healthy Start Medibank Basic Accident and Ambulance	2 months
Mildura Health Fund	Five Star Hospital Basic PLus	2 months
onemedifund	Gold Hospital no excess Gold Hospital - $250/$500 Excess	2 months
Peoplecare	Gold Silver Plus Silver Bronze	2 months
Phoenix Health Fund	Gold Top Hospital Silver Plus Essentials Hospital Bronze Plus Mid Hospital Bronze Plus Starter Hospital	2 months
Queensland Country Health Fund	Vital Hospital Better Hospital	2 months
St. Lukes Health	Superior Gold Superior Gold 300, 500, 750, 1000 Young Silver + 250 Young Silver + 500 No Obstetrics Silver + 250 No Obstetrics Silver + 500 Vital Bronze + 500 Vital Bronze + 750	2 months
Transport Health	Gold Top Hospital SilverPlus Select Daily Excess Silver Plus Select Excess Bronze Plus Health choice Basic Plus Public Hospital	2 months
ACA Health	Restricted health fund Gold Deluxe Hospital Gold Private Hospital Bronze Essentials Hospital Basic Hospital	2 months
CBHS health fund	Restricted health fund Active Plus Hospital Limited Hospital Basic Plus Hospital	2 months
Defence Health	Restricted health fund Ultimate Hospital Gold Advantage Hospital Silver Plus Core Hospital Silver Everyday Hospital Bronze Plus Essentials Hospital Basic Plus	2 months
Doctors Health Fund	Restricted health fund Top Cover Prime Choice Smart Starter	2 months
Navy Health	Restricted health fund Premium Gold Hospital Saver Hospital Core Hospital	2 months
RT Health	Restricted health fund Gold Premium Hospital Silver Plus Smart Hospital Bronze Plus Step Up Hospital Bronze Plus First Start Hospital	2 months
Teachers Health Fund	Restricted health fund Top Hospital Mid Classic Mid Hospital Basic Hospital	2 months
TUH	Restricted health fund Gold Ultimate choice Gold Easy Choice Bronze+ Young choice	2 months

How much of the cost does health insurance cover?

All health funds will cover psychiatric care costs in their hospital policies. This amount is generally called a minimum, restricted or limited benefit. This means that no matter what level of hospital cover you have it will at least pay a benefit towards the cost of being treated as a private patient in a public hospital. Additional out-of-pocket expenses you may incur can include:

• Any private hospital or psychiatric facility fees above the equivalent public hospital costs.
• Additional fees for treatments or pharmaceuticals.
• Extra costs associated with particular treatment regimes or optional inclusions.

More expensive mid and top hospital policies may offer additional benefits beyond the minimum amount required by law, or cover additional psychiatric treatments, although this will vary between funds. Also keep in mind that the cost of your health insurance will be inflated if you opt for a couples or family policy.

What should I be aware of when comparing policies?

If you are considering purchasing a hospital policy that covers inpatient psychiatric care, take the following into consideration.

• Restricted benefits. You may encounter this caveat next to psychiatric treatments in the vast majority of policies. Once again, this means the policy only pays the minimum benefits that are legally required. Because these minimum benefits are laid out by the government, it will be practically the same with every fund.
• Waiting period. This is how long you must wait between taking out a policy and being able to claim certain benefits. This will almost always be two months for in-hospital psychiatric benefits, no matter the policy. Two months is the maximum allowable waiting period for claiming psychiatric treatment on a private health insurance policy, even if it is a pre-existing condition.
• Exclusions. These are conditions or circumstances in which the fund will not pay a benefit. Common exclusions can include undergoing treatment outside of Australia, claims made for treatments carried out by unlicensed practitioners and medically unnecessary procedures. It is important to be aware of all exclusions that apply to your health insurance policy.
• Annual benefit limits. These are the maximum amounts that can be claimed for certain treatments in a given year. For example, a policy may apply a benefit limit of up to $400 for psychological treatments. This means the maximum you can claim per year is $400 regardless of whether your benefits are paid as a set fee or as a percentage of costs covered.

Does Medicare cover psychiatric care?

Medicare offers cover for some hospital psychiatric treatment, but only up to certain limits and under certain conditions.

• Up to ten individual and ten group sessions of psychiatric treatment are covered per year.
• Patients must be referred to specialist care by their GP, psychiatrist or pediatric, or they must be under a valid psychiatric treatment and management plan.
• All treatments must be carried out by appropriately qualified practitioners.

Medicare will cover costs related to diagnosis, focused psychological strategies, some medications and treatment assessments as long as they are connected to clinically diagnosable disorders that significantly interfere with a person’s cognitive, emotional or social abilities. Exceptions include dementia, delirium, tobacco addiction and mental retardation, which are not generally covered.

Compare health insurance for psychiatric care

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