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Health insurance for psychiatric care

You can get health insurance for mental health services and Medicare can help too — compare 5+ policies.

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What you need to know

  • Psychiatric services can include treatment for conditions like mood and personality disorders, eating disorders, addiction and other mental health issues.
  • In Australia, private health funds are legally obligated to offer cover for in-hospital treatment
  • You can also get cover with Medicare, though certain rules and restrictions apply.

How does health insurance cover mental health?

Hospital

Hospital (psychiatric services)

All health funds will cover psychiatric care costs in their hospital policies. This is generally referred to as a restricted benefit which means that no matter what level of hospital cover you have, it will pay a benefit towards the cost of being treated as a private patient in a public hospital. If you want psychiatric care with no restrictions, gold tier hospital cover is the only tier that must offer full cover. Private health insurance won't cover you for out of hospital psychiatric services though.

Optical extras

Extras (psychology and counselling)

Comprehensive extras policies can give you access to therapy or counselling sessions with a psychologist without the need for a referral. It can also cover you for other out-of-hospital services including dental, optical and physio.

What psychiatric services does 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)

How mental health is covered by Medicare

Medicare offers cover for some mental health services but there there are limits:

  • You get up to 10 individual and 10 group allied mental health services each year. (During the COVID-19 pandemic, an extra 10 sessions is available until 30 June 2022 for people who have a mental health treatment plan in place.)
  • You will need to be referred to specialist care by your GP and get a mental health treatment plan from your GP.
  • The rebate is only available to people with a diagnosed mental disorder. This can include depression and anxiety.

Health insurance with psychiatric cover

1 - 10 of 14
Name Product Treatments Price Apply
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$169.56
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$176.68
per month
Gold Hospital $750
Gold$750 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$179.21
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$193.76
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$199.94
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$201.49
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$210.09
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$214.04
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$218.77
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$219.35
per month
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Compare up to 4 providers

All prices are based on a single individual with less than $90,000 income and living in Sydney.

Things you should know about health insurance for psychiatric treatment

Looking for the right policy can be tricky. Here are some things worth looking out for that'll make searching easier.

  • Waiting periods. You'll usually have to serve a 2-month waiting period for psychiatric services and rehabilitation, even if your condition is pre-existing.
  • Out-of-pocket expenses. Even with Medicare and health insurance, you might still have gap costs – that is, whatever is left after Medicare and your health insurer pays the benefit you're entitled to, if your doctor charges more than MBS.
  • Restricted benefits. 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.
  • 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.

Psychiatric support

There are several places and resources that can provide mental health services and psychiatric support in Australia. We've listed some below:

Compare more options for health insurance for psychiatric care

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2 Responses

  1. Default Gravatar
    JaneneOctober 30, 2017

    Hi,
    Im looking for a health fund that covers Mental health private hospital care,

    • Default Gravatar
      LiezlOctober 31, 2017

      Hi Janene.

      Thanks for your question.

      You may compare mental health insurance options by simply filling in our mental health insurance and therapy treatment form. Kindly note that not all policies provide full coverage and there may be a difference between what is covered and what you will have to pay yourself, so please make sure to check the policy’s terms and conditions and PDS carefully before purchasing to ensure you have the cover you need.

      I hope this has helped.

      Cheers,
      Liezl

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