About Mental Health services under the Medicare System

About Mental Health services under the Medicare System:

It has been our experience that many people are unsure about the mental health care system, including medicare funded support if they need to see a Psychologist. Below you will find information on common questions about medicare.

Q: How many psychology sessions can I get under the medicare system?

Every person (including children) in possession of a medicare card is entitled to a total of 10 individual psychology sessions per calendar year. This is usually broken down into 6 + 4 sessions, which means initially you can get 6 sessions from your GP, followed by a review with your GP, and a further 4 sessions if required.

Q: How do I get a medicare referral to see a Psychologist?

You need to see your GP and request a Mental Health care plan (MHCP) to see a Psychologist. Your initial MHCP will be for 6 therapy sessions. After this you will require a review by your GP to get another 4 sessions for the calendar year.

Q: Do I still have to pay out of pocket?

Yes and No. The medicare rebate to see a Clinical psychologist is $124.50 per session. This means that the gap you will need to pay depends on how much the Psychologist charges per session. For individuals with significant financial difficulties, including unemployment they can request that their GP refers them under the “bulk bill” option. This means that there will be no gap to pay.

Q: What if both I and my child require a referral for a Psychologist?

Both you and your child are entitled to 10 sessions of psychological therapy per calendar year. This means your child can get 10 sessions with one Psychologist and you can get 10 sessions with another Psychologist.

What other mental health services can I obtain under medicare?

Psychological Groups:

In addition to being entitled to receive 10 sessions of individual psychological therapy, you are also entitled to receive up to 10 sessions of group therapy per calendar year, with the rebate per group session being approximately $52.00. Speak to your GP to obtain a referral if you are interested in this option.

Non-directive pregnancy support counselling:

Women that are currently pregnant or have been pregnant within the past 12 months are entitled to three sessions of non-directive pregnancy support counselling with a registered provider of these services. Women are entitled to these 3 sessions in addition to the usual 10 sessions under the MHCP per calendar year. The three sessions are available per pregnancy, per calendar year and the rebate is $62.20 per session. If you are currently pregnant or have been pregnant within the last 12 months and are experiencing anxiety, depression or stress related to the pregnancy please speak to your GP about getting a referral to this service.

Extended care plan (ECP) for chronic illness:

– Individuals that have been diagnosed with a chronic health condition (e.g: diabetes) are entitled to five consultations with an allied health practitioner per annum. These five sessions can be utilised to see any allied health practitioner, including a Psychologist.
– Speak to your GP if you are currently living with a chronic health condition that is impacting on your mental health.

What if I have used up all my MHCP sessions and require further therapy sessions?

– It has been our clinical experience that often 10 sessions are not sufficient to address all of a person’s therapeutic needs. It is therefore important to discuss and plan for ongoing psychological therapy if you run out of the standard 10 sessions per year and to discuss further options for treatment with your Psychologist and your GP. Depending on your circumstances, you may be able to utilise the options outlined in the above section (e.g.: pregnancy support counselling, ECP, group therapy).

– If you are with a private health fund you can contact them to find out if they provide rebates for psychological therapy.

Alternatively, you can discuss the option to taper off session frequency with your Psychologist (if it is appropriate and safe to do so) so you continue to get support until you are entitled for a new 10 sessions for the next calendar year.

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