Medicare Australia

Medicare rebates for Psychological Services depend on having the appropriate Mental Health Plan from the referring doctor. The Anxiety Clinic offers psychology services under the Better Access  to Mental Health scheme that allows for 10 individual and 10 group sessions for those referred under a Mental Health Care Plan. 

The Anxiety Clinic has Outpatient Programs that provide a customized intervention for referred patients using cognitive and behavioural strategies in targeted CBT care plans. There is only limited access to fee rebates under Medicare or Private Health cover, but out-of-pocket costs will contribute to eligibility for the Medicare Safety Net. These arrangements will vary with the individual patients depending on the number of eligible sessions available under the Better Access program for the calendar year, and the level of cover offered by the patient’s Health Fund. The Outpatient Program model does not require hospitalization, is able to implemented by working people (on an adjusted work program), and provides state-of-the-art psychological therapy for Anxiety, OCD and related disorders.  Whilst innovative in Australia, such programs are provided regularly in the USA.
 

This is a summary of important information about Medicare rebates that are available for psychological treatment by registered psychologists under the Australian Government’s Better Access to Mental Health Care initiative.

• All psychologists are legally required to be registered with the national registration board, the Psychology Board of Australia, Psychologist Registration Board in their State or Territory, in the same way medical practitioners must be registered. This means that they must be competent and follow a strict Code of Conduct.
• Psychologists specialise in providing therapies for mental health problems. These therapies are effective at treating common mental health conditions including anxiety and depression and most childhood problems.
• You must be referred to the psychologist by your GP, your psychiatrist or paediatrician. Your GP will need to complete a detailed mental health assessment and prepare a Mental Health Treatment Plan before referring you to a psychologist. You should book a longer session with your GP to enable time for this.
• The Better Access initiative covers people with mental disorders arising from:
  • Psychotic disorders
  • Schizophrenia
  • Bipolar disorder
  • Phobic disorders
  • Anxiety disorder
  • Adjustment disorder
  • Depression
  • Sexual disorders
  • Conduct disorders
  • Bereavement disorders
  • Post-traumatic stress disorder
  • Eating disorders
  • Panic disorder
  • Alcohol use disorders
  • Drug use disorders
  • Sleep problems
  • Attention deficit disorder
  • Obsessive compulsive disorder
  • Co- occurring anxiety and depression.
• Eligible people can receive:
  • Up to 10 individual services in a calendar year. Your referring doctor will assess your progress after the first six sessions.
  • Up to 10 group therapy services in a calendar year where such services are available and seen as appropriate by your referring doctor and the psychologist.
• Costs The cost to you will vary depending on the length of the session and the fee being charged by the psychologist. You may claim a rebate by lodging a claim through Medicare. 

Does the Medicare Safety Net apply to my out-of-pocket expenses under this scheme?

Yes. You are responsible for paying any charges in excess of the Medicare rebate for services under this scheme. However, these out-of-pocket expenses will count towards the Medicare Safety Net. The Medicare Safety Net is designed to protect high users of health services from large out-of-pocket expenses.

For more information on the Medicare Safety Net: www.humanservices.gov.au

What about my private health insurance?

You cannot use your private health insurance ancillary cover to top up the Medicare rebates for these services. You need to decide if you will use Medicare or your private health insurance ancillary cover to pay for psychological services you receive. You can either access rebates from Medicare by following the claiming process or claim where available on your insurer’s ancillary benefits.

For more detailed information, please check The Australian Psychological Society: www.psychology.org.au and Australian Government Department of Health and Ageing: www.health.gov.au