Mental Health & Health Insurance

Pathway 1: Medicare (outpatient — no private insurance needed)

Service	Medicare Rebate	Out-of-Pocket	Access
GP Mental Health Treatment Plan	Free (bulk-billed) or {{MHTP_GAP_RANGE}} gap	{{MHTP_OOP_RANGE}}	See your GP
Psychologist (under MHTP)	{{MEDICARE_PSYCH_REBATE}}/session (up to 10/year)	{{MEDICARE_PSYCH_GAP_RANGE}} gap per session	GP referral required
Psychiatrist consultation	{{MEDICARE_PSYCHIATRIST_REBATE}} rebate on schedule fee	{{PSYCHIATRIST_GAP_RANGE}} gap	GP referral
Mental health social worker	{{MEDICARE_SW_REBATE}}/session (under MHTP)	{{SW_GAP_RANGE}} gap	GP referral

How to access: Ask your GP for a Mental Health Treatment Plan (MHTP). This provides access to 10 individual psychology/allied health sessions per calendar year with Medicare rebates. Your GP reviews the plan every 6 sessions.

Pathway 2: Extras insurance (outpatient — supplements Medicare)

Service	Basic Extras	Mid Extras	Top Extras	Waiting Period
Psychology	{{BASIC_PSYCH_REBATE_RANGE}}/session	{{MID_PSYCH_REBATE_RANGE}}/session	{{TOP_PSYCH_REBATE_RANGE}}/session	2 months
Annual limit (psychology)	{{BASIC_PSYCH_LIMIT}}	{{MID_PSYCH_LIMIT}}	{{TOP_PSYCH_LIMIT}}	—
Counselling	❌ Most exclude	⚠️ Some include	✅ {{TOP_COUNSELLING_LIMIT}}/yr	2 months
Approx. sessions covered	{{BASIC_PSYCH_SESSIONS_EST}}	{{MID_PSYCH_SESSIONS_EST}}	{{TOP_PSYCH_SESSIONS_EST}}	—

How to access: Visit any registered psychologist or counsellor. Claim via HICAPS at the provider or submit receipts through your insurer's app. No GP referral needed for extras claiming (unlike Medicare).

You cannot claim both Medicare and extras on the same session. They cover different sessions or different providers. Some people use their 10 Medicare-rebated sessions first, then use extras benefits for additional sessions beyond the Medicare allocation.

Pathway 3: Hospital insurance (inpatient psychiatric admission)

Service	Gold	Silver	Bronze	Basic	Waiting Period
Psychiatric hospital admission	✅	✅	✅	✅	2 months
Inpatient depression program	✅	✅	✅	✅	2 months
Inpatient anxiety program	✅	✅	✅	✅	2 months
Eating disorder inpatient	✅	✅	✅	✅	2 months
Substance use/addiction inpatient	✅	✅	✅	✅	2 months
PTSD inpatient program	✅	✅	✅	✅	2 months
ECT (electroconvulsive therapy)	✅	✅	✅	✅	2 months

How to access: Referral from a psychiatrist to a private psychiatric hospital or ward. Your insurer covers hospital accommodation, nursing care, treatment programs, and psychiatrist consultations during the admission. You pay your excess and any psychiatrist fee gaps.

Use Medicare (Pathway 1) when:

• You need regular psychology or psychiatry appointments
• You're managing an ongoing mental health condition with outpatient care
• You're starting treatment and want to try therapy before considering other options
• You don't have extras cover but need professional support
• You've been referred by your GP for a specific mental health concern

Use Extras (Pathway 2) when:

• You've used your 10 Medicare-rebated sessions and need more
• You want to see a psychologist without a GP referral
• You're seeing a counsellor (not covered by Medicare)
• You want higher rebates per session than Medicare provides
• You're accessing multiple allied health services (physio + psych + other)

Use Hospital cover (Pathway 3) when:

• Outpatient treatment hasn't been sufficient
• Symptoms are severe enough to require 24-hour supervised care
• A structured intensive inpatient program is recommended by your psychiatrist
• You need medication adjustment in a supervised environment
• You need a higher level of care than weekly outpatient sessions provide

Private psychiatric hospitals and units offer intensive, structured treatment programs typically lasting 2-8 weeks. These programs involve daily psychiatric review, group and individual therapy, medication management, and a multidisciplinary team approach.

What inpatient programs typically include:

• Daily psychiatrist consultation
• Structured group therapy (CBT, DBT, schema therapy, mindfulness)
• Individual therapy sessions
• Medication review and adjustment under supervision
• Nursing care 24/7
• Occupational therapy and life skills
• Discharge planning and step-down support
• Day programs post-discharge (some facilities)

Costs with hospital insurance:

Component	Covered?	Out-of-Pocket
Hospital accommodation	✅ At agreed facilities	$0
Nursing care	✅	$0
Treatment programs	✅	$0
Psychiatrist (during admission)	⚠️ Partially (MBS schedule)	{{PSYCH_INPATIENT_GAP_RANGE}} gap
Your excess	You pay	{{PROFILE_EXCESS_RANGE}} per admission

Without insurance, private psychiatric admission costs {{PSYCH_DAILY_RATE_RANGE}} per day. A 3-week admission could cost {{PSYCH_3WK_COST_RANGE}}. Public psychiatric care is available at no cost through public hospital psychiatric wards.

Some insurers cap psychiatric admission days per year. {{POLICIES_WITH_PSYCH_DAY_LIMIT_COUNT}} policies in our database have day limits on psychiatric admissions — check your PDS.

All {{TOTAL_HOSPITAL_POLICY_COUNT}} hospital policies include inpatient psychiatric services. Choose any hospital tier to access mental health hospital coverage.

For extras psychology benefits, use the filters below:

Filter Panel:

• Service: [Psychology] [Counselling]
• Extras Level: [All] [Basic] [Mid] [Top]
• Min Rebate/Session: [Slider: $0 — {{MAX_PSYCH_REBATE_PER_SESSION}}]
• Min Annual Limit: [Slider: $0 — {{MAX_PSYCH_ANNUAL_LIMIT}}]

Table Columns: Insurer | Policy Name | Extras Level | Psych Rebate/Session | Annual Psych Limit | Counselling Included | Premium/wk | [Compare]

Prices are indicative only, sourced from PrivateHealth.gov.au as at {{LAST_UPDATE_DATE}}. Medicare psychology rebates are separate from extras and are not shown in this table. Always confirm benefits directly with the insurer before purchasing.

Factor	Public	Private (with insurance)
Emergency/crisis care	Immediate (ED, crisis teams)	Immediate (ED) + private admission
Inpatient wait time	Varies — priority based on acuity	Typically shorter for planned admissions
Choose your psychiatrist	No (allocated by hospital)	Yes (at agreed facilities)
Facility type	Public hospital psychiatric ward	Dedicated private psychiatric hospital
Program range	Standard programs	Broader specialised programs
Room type	Shared ward	Private or semi-private
Duration flexibility	Shorter stays (bed pressure)	Longer stays as clinically indicated
Day programs post-discharge	Some public services	More commonly available
Cost	Free	Excess + potential psychiatrist gaps

Public mental health care is excellent for acute crises. Public psychiatric wards handle emergency admissions, acute psychosis, suicidal crises, and involuntary treatment orders. For these situations, the public system responds regardless of insurance status.

Private psychiatric hospitals offer advantages for planned admissions — particularly for structured programs (eating disorders, addiction, PTSD) where choosing your facility and psychiatrist, having a private room, and accessing specialised programs matters.

Your employer cannot access your health insurance claims. Your claims history is confidential between you and your insurer. Whether you claim for psychiatric admission, psychology sessions, or any other service, your employer has no access to this information — even if your insurance is through a workplace scheme.

Medicare claims are also confidential. Your GP Mental Health Treatment Plan and psychology sessions claimed through Medicare are not disclosed to employers, insurers (other than your health insurer for relevant claims), or any other party without your consent.

If you apply for life insurance, income protection, or TPD insurance in the future, you may be asked about your mental health history. This is separate from health insurance and is covered by different disclosure rules. Accessing mental health treatment through your health insurance does not automatically affect your life insurance, but your medical history may be relevant to future life insurance applications.