Seeking mental health support can be a big enough step without having to decipher Medicare rebates, private health insurance and out-of-pocket costs at the same time.
Unfortunately, there isn’t one simple answer to the question, “How much does therapy cost?” The amount you pay can depend on the practitioner, the type and length of appointment, whether you have a referral and Mental Health Treatment Plan, and whether you’re eligible to claim through Medicare or private health insurance.
The good news is that a few questions before you book can give you a much clearer idea of what you’ll actually pay.
Start with the full cost of the appointment
Before looking at rebates or benefits, find out the practitioner’s full session fee.
For example, if an appointment costs $200 and you’re eligible for a $90 rebate, your actual out-of-pocket cost would be $110. It sounds simple, but focusing only on the rebate can make it difficult to compare practitioners properly.
Before booking, it’s worth asking:
- What is the full fee and how long is the appointment?
- What rebate or benefit might apply?
- What will my estimated out-of-pocket cost be?
- Is there a cancellation or rescheduling fee?
- Does the cost differ for telehealth and in-person appointments?
It’s also worth finding out whether you’ll need to pay the full amount upfront and claim the rebate afterwards, or whether the practice can process the claim for you.
Using Medicare for mental health support
If you’re eligible, Medicare may cover part of the cost of seeing a mental health professional under a Mental Health Treatment Plan.
A GP or another eligible health professional will first need to assess whether a plan is appropriate for you. Eligible patients can currently receive Medicare benefits for up to 10 individual and 10 group mental health treatment services per calendar year.
Importantly, having a Mental Health Treatment Plan doesn’t necessarily mean your appointments will be free.
Mental health professionals set their own fees. Some bulk bill, while others charge more than the Medicare benefit, leaving you to pay the difference.
Before your first appointment, ask the practice what the full fee is, what Medicare rebate applies and approximately how much you’ll be left to pay.
For the latest information about Mental Health Treatment Plans, referrals and Medicare benefits, check Services Australia’s Mental Health Care and Medicare information.
What about private health insurance?
Depending on your policy, private health insurance extras may provide benefits towards psychology or counselling appointments.
This varies considerably between policies. Your benefit can depend on the type of practitioner you see, whether they’re recognised by your insurer, the type of appointment and the annual limits attached to your extras cover.
Before booking, check whether your policy covers psychology, counselling or both, how much you can claim per appointment and how much of your annual limit you have remaining.
It’s also worth checking whether telehealth appointments are covered and whether your insurer requires a particular provider number or information on your receipt.
If you’re unsure how extras policies generally work, Compare Club’s guide to extras cover explains some of the different services and benefits that may be included. Your own insurer can then confirm exactly what applies to your policy.
Generally, you can’t claim both a Medicare rebate and a private health insurance benefit for the same appointment, so check which option applies before making a claim.
Paying for therapy yourself
You don’t necessarily need to use Medicare or private health insurance to see a therapist.
Many practitioners accept private, self-funded bookings without a Medicare referral, although individual requirements vary. This can sometimes give you more flexibility when choosing a practitioner, particularly if the person you would like to see doesn’t provide Medicare-rebatable services.
The trade-off, of course, is that you’ll be responsible for the full cost.
If you expect to attend regularly, look beyond the cost of one appointment. A $150 session has a very different impact on the household budget when it’s weekly rather than monthly.
You can also ask whether the practitioner offers different appointment options or reduced-fee sessions and how often their fees are reviewed.
Finding the right support matters too
Cost is important, but it isn’t the only consideration.
The relationship you have with your psychologist, counsellor or therapist can play an important role in how comfortable you feel seeking support. If a practitioner offers a brief introductory phone call, it can be a useful opportunity to ask about their approach and whether they have experience in the area you’re seeking help with.
For women seeking support during pregnancy or after birth, mental health care can also form part of a wider network of pregnancy and postnatal services. The Mums of the Shire Pregnancy, Birth & Beyond Guide brings together local practitioners and services available across the Sutherland Shire.
A quick cost check before you book
You don’t need a spreadsheet to work it all out. Before committing to regular appointments, write down:
- the full session fee
- any Medicare rebate or private health benefit you may be eligible for
- your estimated out-of-pocket cost
- how many Medicare sessions or private health benefits you have remaining
- any GP or referral costs
- cancellation fees
- how frequently you expect to attend.
Then confirm the figures directly with the practitioner, Medicare or your private health insurer.
Mental health support is personal, and so is the way you pay for it. Understanding the likely costs upfront won’t answer every question, but it can remove one piece of uncertainty and help you make a more informed decision about the support that works for you.
This article provides general information only and is not medical or financial advice. Medicare eligibility, rebates and private health insurance benefits vary according to individual circumstances. Confirm current information with your healthcare practitioner, insurer or the relevant government service.
This article is not intended as a crisis support resource. If you or someone else is in immediate danger, call Triple Zero (000).
