Mental Health Care Plan in Australia

We all experience daily stresses in life, which can take a toll on our mental health. Thankfully, the Better Access initiative offers affordable professional mental health care to Aussies. One of its key components is the Mental Health Treatment Plan, which covers up to 10 individual in-person or telehealth counselling sessions per calendar year. In this blog, I will provide you with all the information you need to know about the Mental Health Treatment Plan.

Who is eligible for a Mental Health Treatment Plan?

Every Medicare cardholder in Australia is eligible for a Medicare Rebate.

What does a Mental Health Treatment Plan cover?

A Mental Health Treatment Plan covers up to 10 individual in-person or telehealth counselling sessions per calendar year. You can receive counselling from a psychologist, accredited mental health social worker, or other allied health practitioners such as mental health nurses or occupational therapists. The Medicare rebate may cover the entire cost of your counselling (bulk billed), or it may cover a portion of the fees, with you paying the remaining cost (gap fee).

How can I obtain a Mental Health Treatment Plan?

To obtain a Mental Health Treatment Plan, schedule a visit with your doctor. When you book the appointment with your doctor, you can request a long or double appointment to ensure you have enough time to discuss your concerns and goals with them. During your appointment, your doctor will complete an assessment with you and determine if a Mental Health Treatment Plan would be beneficial for you. They'll also work with you to create a personalised care plan that includes your goals and strategies to support your mental health. Your doctor may ask you to complete a questionnaire to better understand your needs before creating your care plan together.

Can I access a psychologist or allied health practitioner directly to receive treatment through Medicare?

To access mental health treatment under Medicare, you must be referred by your GP, a psychiatrist, or a paediatrician. If a GP is the referring practitioner, they will need to prepare a Mental Health Treatment Plan before referring you to a psychologist or allied health practitioner.

Can I choose my own psychologist or allied health practitioner?

During the appointment with your doctor, you can ask them if they have any recommendations for a psychologist or psychological practice/service. However, you can also conduct your own research and find your own psychologist, mental health social worker, or allied health practitioner. I strongly suggest you do your research and search for one yourself. It's like choosing a pair of pants - you want to shop around to find the right fit! Your doctor will then need to write you a referral to your chosen practitioner or service. Once you have your Mental Health Treatment Plan and Referral, you are ready to get started and can contact the person/service listed on the referral and start discussing making your first appointment.

Can I access any psychologist or allied health practitioner?

Under the scheme, a psychologist, mental health social worker, or allied health practitioner must be registered with Medicare and have a Medicare Provider Number in order to provide services under the Better Access scheme. It’s important to note that not all practitioners opt into this initiative.

How much will it cost me for psychology services?

The cost to you will vary depending on the length of the session and the fee being charged by the psychologist, mental health social workers, or allied health practitioner. The cost for a psychological therapy session is usually greater than the Medicare rebate, so you will need to pay the difference between what the practitioner charges you and the Medicare rebate. In some instances, a practitioner may choose to bulk bill (i.e., aged pensioners, health care card holders), in which case you will not have to pay anything. The payment arrangements will vary, and you should check these with the practitioner or service before commencing your treatment.

Where do counsellors and psychotherapists fit into this?

Counsellor and psychotherapists who are not registered with Medicare are not eligible to provide services under the Better Access initiative. However, this does not mean that they cannot provide counselling and mental health services. They may be registered with other professional bodies, such as the Psychotherapy and Counselling Federation of Australia and the Australian Counselling Association and offer services through various settings such as community services and private practice. Counselling fees are often less than the 'gap' charged by a psychologist, social worker or allied health practitioner who is registered with Medicare. Some people may be able to claim a portion of the cost through their private health fund if their policy covers mental health services. Many counsellors and psychotherapists also offer a sliding scale or reduce fee depending on individual circumstances.

It's important to note that regulations and requirements for counsellors and psychotherapists may vary depending on the state or territory in which they practice, so I recommend you do your research and ensure that the practitioner you choose is properly qualified and registered.

So, where to from here?

As you consider your next steps, it's important to factor in the time commitment you're willing to invest in therapy. While the Better Access Initiative provides a valuable resource of 10 Medicare-subsidised counselling sessions per year with a practitioner, it raises an important question:

What if you find yourself needing more than 10 sessions annually?

This situation is far too common, particularly for those with a history of trauma or exposure to adverse life experiences. If your goal is longer-term therapy, opting for a more financially viable approach may involve choosing a practitioner outside the Better Access Initiative. This decision, however, isn't a one-size-fits-all solution, as its feasibility hinges on the practitioner's fees. Take the time to weigh your options: If you decide on a practitioner with whom you can use a Mental Health Treatment Plan, what will be your out-of-pocket expenses if you choose to continue therapy beyond the initial 10 sessions? Assessing these considerations will help you make an informed decision that aligns with your mental health goals and financial circumstances.