Health Insurance with Psychology Cover

19 March 2018
If you are experiencing mental illness and require psychological support services, it is worth knowing about the psychology cover offered by some health insurance policies.

Around one in five Australians will experience mental illness in some form over their lifetime, according to the Department of Health – whether it’s depression, an anxiety disorder, schizophrenia or a behavioural problem. It is important to seek help when such problems arise.

At the time of writing, 105 out of the 409 hospital and extras policies on Canstar’s database include some psychology cover. Below you’ll find some of these, as well as an explanation of what psychology cover is and how you may be able to use it.

Health insurance policies with psychology

The table below displays a snapshot of hospital and extras policies on Canstar’s database that include some psychology cover, sorted by Star Rating (highest to lowest), then provider name (alphabetically). Please note the results are based on a couple aged 36-59 in NSW.

What is psychology cover?

A comprehensive extras policy for health insurance can include benefits for psychology. This coverage can allow you to claim a rebate for psychology sessions that provide support with issues such as relationship difficulties, anxiety and phobias, stress and pain management and eating disorders. It’s important to note that these types of policies tend to attract a higher premium.

Some health funds allow you to receive treatment from any licensed psychologist, whereas others have restrictions and will cover only a psychologist approved by them. The level of cover, as well as applicable waiting periods and restrictions, can also vary between providers.

If you need guidance choosing a psychologist, talk to your GP or contact the Australian Psychological Society. You can be referred to a psychologist through your GP or a psychiatrist.

What psychology costs can I claim on Medicare?

You can generally claim a rebate for up to 10 psychology sessions a year through Medicare if you take up a mental health care plan through your GP.

Private health insurance reforms in 2018 

As of April 1, 2018, the Australian Government has made it easier for policyholders to access mental health services when needed. These changes include: 

  • Two-month waiting periods can be waived on a one-off basis  for people who want to upgrade or purchase cover for a mental health admission
  • Limits on the number of mental health sessions/treatments a person can access will be removed
  • ‘Benefit Limitation Periods’ for mental health cover will also be removed

These changes have been made to benefit patients with basis-to-medium levels of hospital cover who want to upgrade their cover and immediately access in-hospital mental health services.

Is psychology cover the same as psychiatric cover?

While psychology cover is generally an extras-only inclusion, psychiatric cover is a hospital inclusion that involves the in-hospital treatment of mental, emotional and behavioural problems, rather than seeing a specialist doctor for an arranged meeting.

Australian health funds are legally required to pay for a certain minimum level of psychiatric care in hospitals, but certain health funds will offer higher levels of cover. Mid to top-level policies may cover you for the cost of hospital accommodation and a portion of the medical fees.

Unlike many inclusions that can have waiting periods of 12 months or more, psychiatric cover only comes with a standard waiting period of two months after purchasing a policy.

The table below displays a snapshot of hospital and extras policies on Canstar’s database that include psychiatric cover, sorted by Star Rating (highest to lowest), then provider name (alphabetically). Please note the results are based on a couple aged 36-59 in NSW.

Psychiatrists vs psychologists

Psychiatrists are doctors with extra qualifications, specialising in diagnosing, treating and preventing mental illness, whereas psychologists use counselling and therapy to help people both with and without a diagnosed mental illness function more effectively in life.

There are similarities between the two, as they are both trained to understand how your brain works and can help you develop healthier ways of thinking. However, there are key differences:

  • Psychologists cannot prescribe medications, while psychiatrists can 
  • Psychologists also cannot admit people to hospital 

How to claim

Claiming on your health insurance for psychology sessions (should you have cover) should be a simple process. The steps required will generally look like this:

  1. Present your private health insurance card at the front desk prior to your session
  2. Receive your ‘item number’ after the session is completed
  3. Lodge your claim either through your provider’s app, their online claims service, via email, fax, mail or in person. You’ll usually need to quote both of the above items.

Annual limits usually apply to the amount you can claim on psychology – the higher level of cover you have will generally come with a higher annual limit.

Important contacts

Speaking up about your mental health can be daunting, but the way we approach mental health has changed a lot in the last decade or so. There is plenty of help out there, so if you or a loved one is suffering, the following support services may be able to help:

Phone: 13 11 14

Phone: 1800 551 800

Phone: 1300 301 300

Phone: 1300 224 636

Phone: 1800 187 263

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