What is health insurance for psychology?
Some health insurance providers offer policies that cover psychology, providing benefits for certain services and counselling. Psychology generally falls under the extras component of health insurance, which covers services that Medicare doesn't, like dental, physio and optical. On the other hand, the hospital component of private health insurance can cover for in-hospital treatment for psychiatric services as a private patient.
How does health insurance with psychology cover work?
When seeing a psychologist, you'll need to make sure they're registered with your health fund if you want to make a claim, so it's ideal to establish this upfront. Some psychology practices have HICAPs at the front desk, which will allow you to make an op-the-spot private health insurance claim and pay the difference when your session is done, but this is not necessarily universal. Sometimes, you will need to pay your invoice in full and then submit it to your health insurer for a rebate.
When claiming for hospital psychiatric services as a private patient, you’ll generally need to pay your hospital policy’s excess before receiving treatment. Hospital psychiatric services are covered on a restricted basis on the Basic, Bronze and Silver tiers of hospital cover, whereas the Gold tier does not have this restriction. This restriction means that you’ll only be partially covered for the costs as a private patient in a public hospital.
The benefits, annual limits and sub-limits to claiming and waiting periods often vary from provider to provider. Check a policy’s Private Health Information Statement (PHIS) or contact the provider directly for more information.
What psychological support services are covered by private health insurance?
This will be determined by your provider and the level of cover you have in your policy. Psychological support services that could be included are counselling, psychology services, hospital psychiatric services, stress management and hypnotherapy.
What waiting periods apply to health insurance with psychology cover?
There may be a waiting period before you can make a claim on your extras policy for psychology services, which is usually two months. Some providers may offer to waive this waiting period as part of a sign-up deal, whereas others may impose waiting periods of up to 12 months.
For hospital psychiatric services, the maximum waiting period is two months, regardless of if your condition is pre-existing.
Does Medicare cover psychology?
Medicare can cover some of the cost of mental health treatments. If your psychologist or doctor bulk bills, Medicare will cover the cost of the appointments. If they do not, you’ll need to pay either the full cost or difference between what your mental health professional charges and what Medicare covers. If you pay the full cost and Medicare covers a portion, you can make a claim from Medicare for that set portion. Your mental health professional can also make a claim on your behalf.
Medicare does offer social worker services at no cost. You can access these services by calling Services Australia’s helpline and asking to speak to a social worker or by visiting a service centre. Medicare can also help cover the cost of up to three GP referred counselling sessions if you’re pregnant or have been in the last 12 months.
How can I compare health insurance policies that cover psychology?
When comparing policies, it’s important to look at a range of factors, such as:
- What’s covered and what’s excluded?
- How much will the premiums cost?
- What hospital excess will you need to pay if you make a claim?
- Whether you need cover for pregnancy and birth
- What hospital inclusions do you need?
- What cover do you need for your age and time of life?
It’s important to carefully read the policy documents, such as the PHIS and Target Market Determination (TMD), to see what level of treatment is covered, what’s excluded and what limits apply. This helps ensure that a product you’re considering is right for you.
