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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.

What you need to know

  • Psychiatric services can include treatment for conditions including depression, addiction and other behavioural disorders.
  • 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)

Top 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.

hourglass
No waiting periods on psychology consultations
Some health funds, such as Medibank, let you skip waiting periods for psychology and counselling consultations if you're a new member or you've upgraded your cover to include mental health support. There's typically a 2-month waiting period for this.

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 20 sessions with a mental health professional each year. Your doctor or psychiatrist will refer you for up to 6 sessions at a time.
  • You will need to be referred to specialist care by your GP and get a mental health treatment plan from your GP.
  • If the doctor bulk bills, Medicare can cover the cost of the appointment. Otherwise, you'll need to the full cost or the difference between what they charge and what Medicate covers.

Health insurance with psychiatric cover

All of these hospital policies cover you for psychiatric services as an impatient, while psychology consultations are covered by extras.

Name Product Treatments Price Apply
Gold Top Hospital Excess $750/$1500
Gold$750 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$241.03
per month
Medibank Gold Protect
Gold$750 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$242.50
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$245.63
per month
Frank Gold Hospital
Gold$750 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$247.02
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$249.55
per month
Gold Top Hospital Excess $500/$1000
Gold$500 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$250.45
per month
Medibank Gold Protect
Gold$500 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$260.74
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$265.19
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$265.23
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$266.15
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$272.77
per month
advanced hospital gold
Gold$750 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$273.97
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$288.15
per month
Medibank Gold Protect
Gold$250 excess
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$289.02
per month
  • Cataracts
  • Joint replacements
  • Palliative care
  • Pregnancy and birth
  • Sleep studies
  • Weight loss surgery
  • Rehabilitation
  • Insulin pumps
  • +30 other treatments covered
$291.05
per month
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All prices are based on a single individual with less than $93,000 income and living in Sydney.

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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 fee.
  • 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:

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