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2023’s Best Private Health Insurance for Mental Health Australia

Megan Fraser Fact Checked Updated: 16 November 2023
Types of Health Insurance

The topic of mental health has gained significant attention, particularly with the growing recognition of conditions such as depression, addiction, and other behavioural disorders. Maintaining good mental health is now acknowledged more than ever, increasing people seeking psychiatric care and support.

Given this rise in demand, it is important to understand the insurance options available for psychiatric care. Health insurance policies are critical in enabling access to vital mental health services. This guide aims to provide clarity on the complexities of health insurance coverage for psychiatric care and the various available options.

Key facts

  • Typically, higher tier Hospital insurance offers cover for in-hospital psychiatric treatment.
  • Some health funds cover psychiatric care costs in their hospital policies, often as a restricted benefit.
  • Medicare offers coverage for some mental health services, but there are limits.

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Hospital Coverage for Mental Health

Access to psychiatric services is crucial, and health insurance plays a significant role. While Hospital coverage usually includes psychiatric services, it may be a restricted benefit, which means there could be limitations depending on your coverage level. Opting for gold-tier Hospital cover is generally a good idea for comprehensive psychiatric care with fewer restrictions. However, it’s important to note that Hospital insurance typically doesn’t cover out-of-hospital psychiatric services.

Extras Coverage for Psychology and Counselling

Beyond hospital care, top Extras policies can offer access to therapy or counselling sessions with a psychologist without the need for a referral. These policies also cover other out-of-hospital services, including dental, optical, and physiotherapy. However, there’s typically a 2-month waiting period for psychology and counselling consultations.

Extras Services Beneficial for Mental Health:

How Health Insurance Supports Your Mental Well-being

When you are admitted to a hospital as a private patient, your private hospital insurance will typically cover your accommodation costs and a portion of the medical fees. However, it’s important to note that not all expenses related to your admission will be covered. To avoid any surprises, it’s recommended that you reach out to your health fund, hospital, and doctor to find out the amount covered by your insurance, the amount you will need to pay out-of-pocket, and any other potential costs.

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Potential out-of-pocket expenses include:

Comparing Health Insurance with Psychiatric Cover

Choosing the right health insurance for psychiatric care can be daunting. Here’s a comparison to help you decide:

InsurerProduct NamePsychology (Extras) CoverageWaiting PeriodsMonthly Premium
Bupa HI Pty LtdGold Ultimate Health Cover$1,000 per policy (Initial visit – $134.00, Subsequent visit – $119.00)2 months for hospital psychiatric treatments, even if pre-existing$522.75
CBHS Corporate Health Pty LtdPremium Package (Gold)$500 per policy (Initial visit – $140.00, Subsequent visit – $80.00)2 months for hospital psychiatric treatments, even if pre-existing$477.14
Medibank Private LimitedGold Ultra Health Cover$600 per policy (Initial visit – $136.70, Subsequent visit – $101.50)2 months for hospital psychiatric treatments, even if pre-existing$572.00
National Health Benefits Australia Pty Ltd (onemedifund)Gold Hospital $250 Excess & Comprehensive Extras$500 per policy (Initial visit – $120.00, Subsequent visit – $75.00)2 months for hospital psychiatric treatments, even if pre-existing$405.22
Health PartnersGold Hospital Complete $750 Excess with Combined Best Extras$500 per policy (Initial visit – $100.00, Subsequent visit – $100.00)2 months for hospital psychiatric treatments, even if pre-existing$393.94

Source: Privatehealth.gov.au (August 2023; Premium estimates for an individual living in NSW, Hospital cover estimates for a Gold plan and Extras cover estimates for Top Extras cover)

Best health insurance for mental health

When considering health insurance options that include coverage for mental health, there are a few standout insurers to consider. Bupa, CBHS, and Medibank offer extensive inpatient psychiatric services, with Medibank providing slightly more coverage for psychology (Extras) and Bupa and CBHS following closely behind. National Health Benefits Australia and Health Partners also offer strong mental health coverage.

Remember, all of these insurers have a waiting period of two months for inpatient psychiatric treatments, even if it is a pre-existing condition. When deciding on a policy, it’s important to evaluate your specific needs, budget, and individual factors.

Waiting periods

When it comes to health insurance waiting periods, psychiatric services and rehabilitation are treated differently than other pre-existing conditions. Most conditions require a 12-month membership before hospital admission coverage begins, but the waiting period is only 2 months for psychiatric and rehabilitation services. This means that even if the condition existed before the policy’s start date, you can access coverage after just 2 months of initiating the policy.

Waiting period Exemption

If you have a hospital policy that offers limited benefits for psychiatric care, you may have had to upgrade your policy and wait two months to access enhanced benefits. However, as of April 1, 2018, this process has been simplified. You can now upgrade your policy and immediately access enhanced psychiatric care benefits in a private hospital, without waiting for two months.

Please note that this exemption can only be used once in your lifetime and is only available to those who have completed an initial two-month membership on any level of hospital coverage. For more information on this exemption, please contact your health insurance provider.

Benefits of Buying Cover for Mental Health:

Frequently asked questions

  • Am I covered for inpatient mental health services?

    Regarding mental health services, it’s important to ensure you have the necessary coverage to receive the care you need. That’s why it’s always a good idea to verify the specifics of your insurance plan or consult with your insurance provider directly. By doing so, you can ensure that you’re covered for inpatient mental health services, as well as any other treatments or therapies that may be necessary for your wellbeing. Remember, taking care of your mental health is just as important as taking care of your physical health, and having the right insurance coverage can make all the difference.
  • Am I covered for outpatient mental health services?

    It’s important to note that coverage for outpatient mental health services can differ depending on the insurer and policy. While some may offer coverage for these services, others may not. To ensure you understand the extent of your coverage for outpatient services, it’s essential to check with your insurer.
  • Does health insurance cover psychiatrists?

    Most hospital insurance plans typically cover psychiatric services. Nevertheless, it is crucial to carefully review your policy details or speak with your insurance provider to ensure that you have sufficient coverage for mental health treatment.
  • Will I have out-of-pocket expenses?

    It’s possible to have Medicare and health insurance and still face gap costs or out-of-pocket expenses. This can happen if your medical provider charges more than the Medicare Benefit Schedule fee or for other reasons.
  • Will I have to serve a waiting period for psychiatric care?

    In general, health insurance policies have a standard waiting period of 2 months for psychiatric services. However, it’s important to check your policy documentation or consult with your insurer to confirm any waiting periods that may apply to your coverage.

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