Private Health Insurance for Mental Health – Explained

Private Health Insurance for Mental Health – Explained
Sad adult woman sitting on dark home corridor floor.
Sad adult woman sitting on dark home corridor floor.

As more Australians engage in mental health awareness, the demand for accessible mental health services has grown. For those grappling with mental health struggles, finding the right support is essential – and private health insurance can be a big part of getting you the help you need.

But what exactly is included in mental health cover in Australia? Here, we break down how private health insurance covers mental health services, what to look for in a policy and how the government is working to tackle the country’s mental health crisis.

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Why mental health coverage is so important

Mental health has become a major focus of healthcare in recent years. In fact, 21% of Australians consider mental health cover as being ‘essential’ when choosing insurance, and another 42% view it as ‘important’, according to a recent YouGov survey.

Young Australians, in particular, have to deal with big challenges around mental health, with recent ABS data showing that nearly two in five (38.8%) Australians aged between 16 and 24 have experienced a 12-month mental disorder.

But the reality is that it’s a mental health crisis that extends to all ages and demographics, and with barriers like the rising cost of living preventing many people from being able to access support, mental health cover in private health insurance can make a real difference.

Does my health insurance cover mental wellbeing?

The answer to that question depends on your policy and provider. Health insurers generally include certain mental health services in both their hospital cover and extras cover, but there are big differences between what each one will cover.

1. Hospital cover for mental health

Most private hospital policies include some level of cover for psychiatric treatments, including hospital stays. These can include:

  • In-patient care: Treatment within a hospital setting for conditions like severe depression, anxiety disorders or other mental health crises that require intensive care.
  • Psychiatric services and rehabilitation: Ability to see a psychiatrist who can diagnose and treat mental health conditions, prescribe medications and, if necessary, arrange hospital admissions.


However, it’s important to note that waiting periods and restrictions will apply, especially if the mental health condition is pre-existing. There are
mental health waiting period exemptions where your policy might provide you with a one-time waiver of the usual two-month waiting period for in-patient psychiatric care, but you’ll need to check with your provider to see if this applies to you.


2. Extras cover for mental health

Extras cover can help with out-of-hospital mental health services such as:

  • Counselling and psychology: Many extras policies cover consultations with registered psychologists or counsellors, which are useful for managing stress, anxiety, grief and other struggles.
  • Alternative therapies: Some policies even include treatments like hypnotherapy for stress management, although cover for these services varies from provider to provider. There may also be annual and lifetime limits to how much you can claim back.


You’ll find that many health insurers will cover mental health services without a referral, and most should also have options for telehealth consultations. This means you can connect with a psychologist or counsellor from anywhere, which has proven especially valuable as telehealth becomes more sought after.

The cost barrier to mental health services

For many Australians, cost remains a barrier to getting the mental health services they need. According to a survey from the Australian Psychological Society (APS), 44% of respondents say that cost is the main barrier to accessing psychology services, with three in four (75%) Australians citing cost as a ‘top three’ barrier to care.

Moreover, roughly 45% of people with mental health issues say they can’t afford self-care or well-being programs, while 33% can’t afford medications, according to Headspace’s recent National Youth Mental Health Survey.

If these figures haven’t highlighted the issue already, there’s a great need for more affordable, accessible mental health support – both through private health insurance and government funding.

Portability

Don’t re-serve waiting periods when you switch to a new health fund or policy

“John was immediately covered for a hip replacement in private hospital because he had already served his waiting periods for joint replacements on his old policy”

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Private health insurance mental health services and what to look for

When you start comparing policies and looking into private health insurance mental health services, think about the following factors to find the best fit for your individual circumstances:

1. Types of services covered

Shop around, compare your options before committing and look for policies that cover a broad range of services, such as:

  • Psychiatric hospital stays
  • Out-patient counselling and psychology
  • Alternative therapies (e.g. hypnotherapy, stress management)


2. Waiting periods

Mental health services through private health insurance will have waiting periods, especially for psychiatric hospital stays. Be sure to check whether your provider offers any waivers or options to reduce this waiting period for urgent needs.

3. Annual limits and lifetime caps

Most policies will have annual limits for mental health services, so make sure the cap is enough to cover your expected usage. This limit applies particularly to extras cover, which might only allow you a certain number of psychologist or counselling sessions per year.

4. Flexibility with providers

If you have a preferred mental health provider, check if they’re recognised by your insurer. Some policies allow you to choose any licensed professional, while others will restrict you to their own network of providers. If you’re unsure, contact Fair Health Care Alliance today and we’ll show you which policies will give you the most freedom to choose your mental health care providers.

How the Australian government is tackling the mental health crisis

In response to the growing mental health crisis in Australia, the government has allocated numerous resources to improving mental health research and accessibility.

  • Government-funded research initiatives: The Million Minds Mental Health Research Mission has committed $125 million to mental health research and funding. The funds are in place to support projects that will better understand the mental health impacts of all sorts of stressors. The University of New England, for example, received $5 million to develop community-based mental health programs for those impacted by fires, droughts and other extreme weather events.
  • Medicare and mental health: Medicare has rebates for a limited number of psychologist sessions each year through Mental Health Care Plans. You’ll need a referral from a GP to access these subsidised sessions. While private insurance can give you cover for many more sessions and reduce your out-of-pocket costs, Medicare’s remains a vital resource for Australians without private cover.
  • Calls for expanded support: Advocacy groups, including the Australian Association of Psychologists and the Royal Australian College of GPs, are urging the government to increase Medicare rebates and subsidised session limits to make mental health services more accessible. With 7 out of 10 Australians unable to afford essential mental health services, increasing government support could greatly ease the nation’s mental health burden.

How to find the right mental health cover

Finding insurance for mental health services can feel like an overwhelming task – especially if you are in the middle of a crisis or can’t afford to foot the bill for a psychologist appointment on your own. Here’s a checklist to simplify the process:

  1. Narrow down your specific needs: Think about the services you might need, whether that’s regular psychology sessions or hospital cover for more intensive care.
  2. Compare private health insurance: Look for policies with generous caps on psychology and counselling sessions if you need ongoing support.
  3. Check for telehealth options: Many insurers now cover telehealth for psychology and counselling.
  4. Look into government support: You might be able to use a mental health care plan with Medicare as a supplement if you don’t have comprehensive mental health cover.
  5. Research extra perks: Some private health policies will include wellness programs, access to mental health apps or support groups, which can add some extra value beyond direct care.

Conclusion

If you want to maintain your mental wellbeing over the long-term while also being covered for a portion of your costs, private insurance can be a lifeline. You can start comparing your options today – the Fair Health Care Alliance experts will help you find the right mental health cover for you.

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Private Health Insurance for Mental Health – Explained

Founder at Fair Healthcare Alliance

Aaron Savrone, founder of Fair Health Care Alliance (FHCA), is a health insurance expert with over 15 years of experience. Specializing in transparent, customer-focused advice, Aaron launched FHCA in 2017 to address the lack of genuine care in the health insurance comparison space. With a commitment to simplifying complex policies and data, Aaron and the team have earned FHCA top ratings and awards, including a 5-star Google Review score from hundreds of reviews and Best Insurance Comparison Website in 2023 and 2024 (ProductReview).

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