Mental health under Medicare

If you feel that you are struggling and finding it difficult to cope or manage from day to day, you can talk to your healthcare practitioner about accessing support for mental health conditions like depression or anxiety. If they believe that you require or would benefit from treatment for emotional and/or mental health problems, this can be subsidised under Medicare.

What is involved?

Your GP will make a detailed assessment of your history, symptoms and situation. From this your GP may suggest supports in the community, taking or adjusting  medication and/or suggest psychological treatment.

Following this initial consultation a mental health care plan is developed.  This may come about either by:

1. Your GP preparing a GP mental health care plan themselves, which may involve referring you for psychological treatment.
2. Your GP may refer you to a psychiatrist who will prepare a psychiatrist assessment and management plan which they may oversee in consultation with your GP.
3. Your GP may refer you to a psychiatrist or paediatrician who will conduct the assessment, and from there may directly refer you to other treatment providers (such as allied health workers – psychologists, mental health nurses, social workers, occupational therapists).

What am I entitled to?

Your GP or psychiatrist/paediatrician can refer you for ten individual and ten group allied mental health sessions under your mental health care plan. After the sixth session, you will be required to return to your GP or psychiatrist/ paediatrician for a review of your progress to date.

Mental health sessions may comprise either psychological assessment and therapy by a clinical psychologist or focussed psychological strategies by an allied mental health professional. A rebate is provided by Medicare for these sessions, although you may also have to pay a gap fee.

In exceptional circumstances, dependent on your health care needs, additional sessions may be provided under Medicare.  To access this you will need to return to your GP or psychiatrist/paediatrician who will review your progress to date and current status. They will take into account the written report received from the allied mental health professional to obtain a new referral. 

You may therefore access a maximum of ten individual and ten group services per calendar year – with additional sessions in exceptional circumstances. At this time, a review of your GP mental health care plan may also be undertaken.

Psychological treatments can also be obtained through direct payment to the provider, and if you have private health insurance you may be eligible for a rebate.