Psychology and health insurance, how do I claim?

Ensuring that your private health insurance adequately covers psychology treatments and therapies for mental well-being is a common concern for many individuals. Let’s delve  into the intricacies of coverage for these services with your private health insurance. In this blog we will explore the ways it can assist in managing your mental health, and how you can navigate the process of claiming these benefits.

When it comes to private health insurance, it’s not just about coverage for medical treatments but also about taking care of your mental health. One essential aspect is having extras, which may include benefits for psychology and counseling services. These policies typically involve your health fund covering a predetermined amount or a percentage of the service cost, leaving you responsible for the remaining balance.

Understanding the scope of coverage is crucial, as not all private health insurance plans include the same mental health services. Some common services that may be covered include counseling, provided by professionals such as psychologists, nurses, social workers, or occupational therapists. Psychologists can offer various therapies for conditions like depression, anxiety, grief, and stress. Additionally, private health insurance may extend to hospital psychiatric services, involving the expertise of psychiatrists who can prescribe medications and admit patients to hospitals.

For those dealing with stress-related conditions, some policies may cover stress management services and courses provided by recognised providers. Hypnotherapy, a therapeutic technique involving a trance-like state, may also be included in certain plans. Furthermore, individuals with hospital or package cover often have access to a 24/7 Mental Health Support Line, providing support whenever it’s needed.

Understanding the fine print is crucial, as waiting periods and annual limits may apply to these mental health services. Providers must be recognised by your private health fund before they can contribute to the bill. Some plans even offer a mental health waiver, allowing access to hospital psychiatric services after a 2-month waiting period for restricted psychiatric services, without reserving the waiting period.

A critical component of accessing mental health services is having a Mental Health Care Plan, officially known as a Mental Health Treatment Plan. This plan is a brief document created by your General Practitioner (GP), Psychiatrist, or Paediatrician after assessing your current mental health status. It serves as a gateway to receiving rebated sessions with a registered psychologist, with up to 10 Medicare-rebated sessions available each calendar year.

While you may wonder why you need to see a doctor to see a psychologist, the rationale is that your GP serves as your primary health professional. They have a comprehensive understanding of your medical and personal history, making them well-placed to oversee your general health. In addition, GPs can prescribe medication, a capability psychologists lack. Although it may mean answering similar questions during assessments, the GP’s focus is on establishing a diagnosis for a Mental Health Care Plan, while the psychologist’s aim is to create a therapy-focused map of your current situation.

In summary, navigating mental health coverage involves visiting your doctor to obtain a Mental Health Care Plan, taking it to a psychologist for up to 6 rebated sessions, returning to your doctor for a Mental Health Care Review, and potentially having up to 4 more rebated sessions with a psychologist. It’s a structured process that aims to provide comprehensive mental health support.

For more information on private health insurance coverage for mental well-being, our team is here to assist you. Feel free to reach out to us at 1300 861 413 or email us at

Your mental well-being is a priority, and we’re here to help you navigate the complexities of private health insurance to ensure you receive the support you need.

One of the most asked questions is does my private health insurance cover psychology and treatments for the well-being of my mental health?

General treatment (extras) insurance for psychology and counselling. Some general treatment or extras policies you can purchase will also provide benefits towards psychology services and counselling. Your health fund will pay a set benefit or percentage of the cost of the service, and you pay the rest.

Here’s a list of mental health services and treatments some private health funds can help with the bill for, but they aren’t all included in every type of cover. Waiting periods and annual limits apply, and all extras providers must be recognised by ahm before we can help with the bill.


Talking therapy that can be offered by a psychologist, nurse, social worker or occupational therapist.


Hospital psychiatric services 

Stress management 

Services and courses provided by a recognised provider to manage and prevent health conditions associated with high levels of stress. 


Therapy that involves putting people into a trance-like state, intended to promote focus and receptiveness to suggestions in an individual. 

24/7 support Members who have hospital or package cover have access to a 24/7 Mental Health Support Line.

Mental health waiver After a 2 month waiting period for restricted psychiatric services you can access a waiver to upgrade to cover with included hospital psychiatric services (without re-serving the waiting period). Terms and conditions apply.

What is A Mental Health Care Plan?

A Mental Health Care Plan (or a Mental Health Treatment Plan as it’s officially called) is a brief document created by your General Practitioner (GP), Psychiatrist, or Paediatrician that reviews your current mental health.

To obtain a Mental Health Care Plan you’ll need to sit down with your Doctor and complete an assessment. During this time they’ll check in on your current coping, take a short history and may ask you to complete a questionnaire.

Once this is completed your Doctor will create your plan which makes you eligible to receive 6 rebated sessions with any registered Psychologist courtesy of Medicare. After your 6 sessions you can return to your Doctor to get a “review” of your Mental Health Care Plan which may land you another 4 sessions

So each calendar year you’re entitled to receive up to 10 Medicare rebated sessions with a Psychologist.

Why Do I Have To See A Doctor To See a Psychologist?

There are a few different ideas on this, but the main view is that you GP is your main health professional. Ideally they know your medical and personal history so they are best placed to act as the overseer of your general health. They are also able to prescribe medication which a Psychologist can not do, so it’s generally helpful to have them in the loop.

Unfortunately, it does tend to mean that you’ll be asked the same questions by your Psychologist and your GP as they both have to do assessments. However, the assessments tend to have distinct aims. Whereas the GP is trying to establish a diagnosis for a Mental Health Care Plan, the Psychologist’s assessment aims to create a map of your current situation to determine the best course of therapy.

Of course, if you don’t want to involve your GP in the process of seeing a Psychologist you can still book and attend sessions. You just want be able to claim anything back through Medicare.

How Do Mental Health Care Plans Work?

Okay so let’s summarise:

  1. Visit your Doctor to get a Mental Health Care Plan
  2. Take your completed Mental Health Care Plan to a Psychologist and attend up to 6 rebated sessions
  3. Back to the Doctor to get a Mental Health Care Review done
  4. Have up to 4 more rebated sessions with a Psychologist

Our team is here to assist you with information surrounding cover for the well-being of your mental health. Feel free to call us at 1300 861 413 or email us at

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