Your guide to mental health care plans in Australia

We all have tough days. But when things feel overwhelming, a bit of help can get us back to feeling ourselves again. And thanks to Medicare, you can access support for your mental illness by getting a mental health plan. 

What is a mental health care plan? 

A Mental Health Treatment Plan (or a mental health care plan) is a way to get ongoing support if you’re experiencing mental health issues. 
 
“It’s meant to state your diagnosis (and maybe symptoms) and your plans and goals for therapy,” explains Dr Hamish Black, nib Group Medical Advisor. 

You can make a mental health plan with your GP, psychiatrist or paediatrician. This plan lets you claim a Medicare rebate for: 

• 10 individual psychological appointments  

• 10 group allied mental health services per calendar year. 

No two mental health plans are the same. Some might include support from other specialists, like social workers or occupational therapists. Others might only have support from a GP and psychologist. 

Heads up: You won’t get all your sessions in one go. After your first six, you’ll check in with your GP to see if you need more. 

Who can get a mental health plan? 

You can get a mental health care plan if a doctor has diagnosed you with a mental health disorder. Beyond that, “anyone who is Medicare eligible and hasn’t used the total number of therapy sessions that calendar year is eligible,” says Hamish.

How to get a mental health plan 

When your mental health takes a hit, asking for help can be difficult. Luckily, getting a mental health plan in Australia is a simple process: 

• Step 1: Book an appointment with your GP 
  Let them know you want to discuss a mental health plan. 

• Step 2: Assessment 
  Your GP will ask you some questions about your mental health. Take your time and answer honestly. This will help the GP work out the level of support you need. 

• Step 3: Creating a plan 
  They’ll fill out your mental health treatment plan and discuss short and long-term goals. 

• Step 4: Referral 
  You’ll get a referral to a mental health professional, like a psychologist. 

Do you need a referral to get a mental health plan? 

Nope, you don’t need a referral to speak to your GP about a mental health plan. But as we touched on before, your GP might give you a referral to a mental health professional as part of your plan. 

How much will your appointments cost with a mental health plan? 

While the 10 psychology sessions Medicare offers are free, there might be other costs too.  
 
“Drawing up the plan may be free if your doctor bulk bills,” says Hamish. “Otherwise, the price is the gap between what Medicare will pay and what your doctor is charging. Similarly, there is usually a gap between what your psychologist will charge and what Medicare will reimburse.” Medicare might rebate some of the costs for your appointments. Plus, if you have the right private health coverage, you could claim benefits for some sessions if you need more than the 10 in your plan.  
 
The downside is that health insurance doesn’t cover any gaps if your session is eligible for a Medicare rebate. The best idea is to check with your health insurance provider to find out if you are eligible for rebates. 

How long does a mental health care plan last? 

Your mental health care plan can last as long as you need it. Once your 10 sessions are used, you’ll need to book a new plan with your GP. 
 
 It’s a good idea to review your plan after three or six months. There’ll generally be a review date written on your plan. After about 12 months, you GP might draft a new plan if you need extra support. 

At nib, we’re here to support you 

We understand the importance of mental health and wellbeing. That’s why we have a range of Extras cover options with psychology inclusions to help cover the costs of your therapy sessions. If you want to chat with our friendly team about our Extras options, then you can call us on 13 16 42. 

And if you’re an eligible nib member, you can access our mental health management programs. These programs provide different solutions to improve your mental wellness.  Remember, if you or someone you know needs help please call: 

• Lifeline: 13 11 14 

• Beyond Blue: 1300 22 4636 

• Kids Helpline: 1800 55 1800 

 Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.