Mental health care is a big umbrella, but includes treatment for conditions including depression, anxiety, psychosis, OCD and eating disorders. Treatment can be provided in hospital or outside hospital - it matters which as it relates to having your treatment covered by Medicare or health insurance.
If this is something on your mind, the best place to start is with your GP. This guide will give you some more insight on how the health insurance process works around mental health, but your journey will be unique, so start with your doctor.
Medicare, Australia's public health system, offers a range of mental health support services, although there are 2 primary routes worth going over.
Unfortunately, the public system is under a lot of stress, especially around mental health care. Hospital mental health departments tend to be under resourced and in demand, and outpatient clinics are generally very hard to get an appointment for.
As such, there is a lot of value to having a private option available.
"I got pretty badly depressed a couple of years back. It was f**king terrible if I can be frank. But once I clocked it, which took a lot longer than it should have, I went straight to my GP. He was great, and gave me a mental health plan. Unfortunately, I could not find an available psychologist for love nor money, so I ended up using my work's Employee Assistance Program (EAP). This included a half dozen in-person psychology sessions near the Finder office. It was genuinely life-changing, and I couldn't have got through it without professional help."
Extras health insurance will help pay for some mental health treatments outside of hospital. It's generally a cheaper option, but it won't cover you for any private treatment in a hospital - that's the realm of hospital insurance.
Most extras only health insurance policies include cover for psychology treatments. These services are typically appealing to those who are struggling with any of the following:
Every extras policy is split into categories. The names may vary by provider but it usually follows something like: dental, optical, psychology, etc. Under the psychology category, this is where you'll find the specifics of what's covered in your policy and the benefit limits.
Let's say for example, your provider's psychology category includes the following treatments: psychology sessions, counselling sessions, hypnotherapy and general health improvement. The annual benefit limit for this category might be $200. This means you can claim up to $200 across all the benefits listed under that category. You may choose to spend the whole $200 on psychology sessions or you may choose to claim $100 for psychology, $50 for hypnotherapy and the remaining $50 for general health improvements. The choice is yours.
When accessing the psychology benefits on your extras policy, waiting periods may apply. Generally speaking you'll have a 2 month wait before you can make a psychology claim, but it varies a lot from provider to provider. Some even waive the waiting periods altogether, either for psychology specifically, or as part of a larger sign-up offer.
A gold hospital policy is the only level of cover to fully cover psychiatric care. That makes private hospital coverage for mental health care quite expensive - that is somewhat reasonable from the health fund's perspective, because residential care is really expensive to provide! However, it does make getting help when you need it a bit tricky.
The good news is there are special rules around hospital cover for psychiatric conditions that make it a bit more accessible.
Hospital insurance covers inpatient care. This means you're covered when you check into a hospital 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:
There are some special rules around hospital cover waiting periods for psychiatric care specifically. Here's what you need to know:
There are several free and confidential resources available for those who are concerned about their mental health and want access to free help or support.
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Hi,
Im looking for a health fund that covers Mental health private hospital care,
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