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What is covered by Australian health insurance for mental health?

Prompt

Last updated 25th September 2025

Domain count
health.gov.au
2
money.com.au
1
canstar.com.au
1
Citations count
27
4
12
11
Brands Discovered
8
4
3
2

Original answer

Short answer

  • Medicare (through the Better Access / mental health treatment plan pathway) provides rebates for a limited number of allied‑mental‑health and psychology sessions each calendar year. (health.gov.au)
  • Private health insurance can help with inpatient psychiatric treatment (if your hospital cover includes psychiatric services) and may reimburse some out‑of‑hospital psychology/counselling through Extras — but cover, limits and waiting periods vary a lot between funds and policies. (money.com.au)

What Medicare (federal government) typically covers

  • Better Access / Mental Health Treatment Plans: If a GP, psychiatrist or paediatrician assesses you as having a diagnosed mental disorder they can create a mental health treatment plan and refer you to eligible allied mental health professionals (psychologists, clinical psychologists, eligible social workers and occupational therapists). Medicare rebates are available for those referred services. (health.gov.au)
  • Annual limits: Medicare rebates apply for up to 10 individual and 10 group allied mental health services per calendar year (you can still receive more treatment, but Medicare won’t rebate beyond these limits). Telehealth MBS items remain available. (health.gov.au)
  • Psychiatrists: Consultations with psychiatrists (specialist medical practitioners) attract MBS items and may be rebated by Medicare (different rules and item numbers apply). GP referrals are normally required for access to some MBS items. (health.gov.au)
  • Medications: Prescription psychiatric medications are not paid for by private health insurance; they are accessed via the Pharmaceutical Benefits Scheme (PBS) or paid privately. Private health or Medicare generally does not cover outpatient medicine costs. (money.com.au)

What private health insurance typically covers

  • Hospital cover: To have inpatient psychiatric treatment covered in a private hospital you need Hospital cover that includes psychiatric/mental health services; many funds restrict psychiatric cover to higher tiers (Gold) or provide restricted cover on lower tiers. If admitted as a private patient, hospital and some specialist costs may be covered (subject to policy rules, excesses and gap payments). (money.com.au)
  • Extras cover: Extras (ancillary) policies sometimes include rebates for psychology, counselling or allied services (with annual limits, per‑session limits, provider rules and waiting periods). Not all funds or extras policies include psychology and amounts vary widely. (money.com.au)
  • Waiting periods and restrictions: New policies usually have waiting periods before you can claim; psychiatric benefit entitlements and waiting‑period exemptions are subject to recent reforms and specific conditions — always check your fund’s Product Disclosure Statement (PDS). (canstar.com.au)

Common exclusions / things not usually covered

  • Routine outpatient psychology visits are only partly covered by Medicare (limited sessions) or by Extras with caps — many people still pay an out‑of‑pocket fee. (health.gov.au)
  • Most private policies don’t pay for prescriptions (use PBS) or for unregistered/alternative therapies unless specifically listed. Some digital therapy programs and certain clinic‑based services may or may not be covered depending on your fund. (money.com.au)

Practical steps to find out exactly what applies to you

  1. Ask your GP about a mental health treatment plan / Better Access referral if you might be eligible (they’ll assess and can refer). (health.gov.au)
  2. Check your private health fund’s PDS or contact them to confirm: (a) whether psychiatric inpatient care is covered and under what tier, (b) what Extras (psychology/counselling) benefits and limits apply, and (c) waiting periods and gap arrangements. (money.com.au)
  3. If cost or access is a concern, ask about bulk‑billing options, community mental health services, Aboriginal Community Controlled Health Organisations (if relevant), or local services that offer low‑cost care. (medicarementalhealth.gov.au)

If you need immediate help

  • In an emergency call 000. Lifeline 13 11 14 (24/7) and other crisis lines are available nationally. (These are general crisis resources; check local services if you want options in your area.)

If you’d like, I can:

  • look up a specific private health fund’s PDS or the current Medicare rebate amounts for particular MBS items, or
  • summarise what a particular insurer’s policy says about psychiatric and psychology cover (tell me the fund/policy name).

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Rank
Brand
Topic
LLM
Sentiment
1
🥇

Medicare

60%
0%
90%
90%
Neutral
2
🥈

health.gov.au

30%
90%
0%
0%
Neutral
3
🥉

money.com.au

28%
85%
0%
0%
Neutral
4

Better Access to Mental Health Care

27%
0%
0%
80%
Neutral
5

THIS WAY UP

27%
0%
80%
0%
Neutral
6

canstar.com.au

25%
75%
0%
0%
Neutral
7

Gold Hospital

25%
0%
0%
75%
Neutral
8

medicarementalhealth.gov.au

23%
70%
0%
0%
Neutral
Domain
Title
LLM
URL
Better Access initiative | Australian Government Department of Health, Disability and Ageing
Openai
Best Private Health Insurance for Mental Health Australia
Openai
How Medicare & Private Health Insurance Cover Mental Health | Canstar
Openai
Understanding costs | Medicare Mental Health
Openai
psychology.org.au
Gemini
servicesaustralia.gov.au
Gemini
comparethemarket.com.au
Gemini
medicarementalhealth.gov.au
Gemini
health.gov.au
Gemini
ombudsman.gov.au
Gemini
medibank.com.au
Gemini
bupa.com.au
Gemini
frankhealthinsurance.com.au
Gemini
ahm.com.au
Gemini
yourhealthinmind.org
Gemini
nib.com.au
Perplexity
choice.com.au
Perplexity
fairhealthcare.com.au
Perplexity
eshealth.com.au
Perplexity
allianzcare.com.au
Perplexity
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