Health insurance for psychiatric care

Compare health insurance for inpatient mental health services.

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
ahm logo 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?

Health fundHospital policies that cover psychiatric services Waiting periods
Picture not described
  • 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
AHM health insurance
  • 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
HCF health insurance
  • Hospital Gold
  • Hospital Silver Plus
  • Hospital Silver
  • Hospital Bronze Plus
  • 2 months
nib health insurance
  • 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 fundHospital 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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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 the e-form on this. 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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