Mental health is a fundamental aspect of our overall wellbeing, yet many Australians are not accessing the mental health services they need. While approximately 1 in every 2 Australians will experience some form of mental illness during their lifetime, the proportion of those accessing mental health services is substantially less. The good news is that your private health insurance coverage could play a role in bridging this gap and promoting mental wellbeing. Beyond its traditional role in physical health, private health insurance may offer significant support for addressing mental health concerns. In this guide we will discuss the ways in which your cover could assist with accessing and covering some of the costs of these services.

Your Extras Cover

In Australia, through the public healthcare system, individuals can access a GP-referred Mental Health Treatment Plan, which grants the ability to claim up to 10 sessions each calendar year with a Medicare registered mental health professional. This means that your GP can refer you to see a psychologist, social worker, or occupational therapist for an initial 6 sessions, with a possible 4 further sessions following a review. Under this plan, you are entitled to Medicare rebates for these 10 sessions.

However, there are situations where you might not be eligible for the Mental Health Treatment Plan due to specific circumstances. In such cases, Navy Health may offer a helping hand through its Premium Extras and Healthy Living Extras products. These products enable you to claim consultations with a registered psychologist if you don’t have a Treatment Plan or have exhausted your yearly quota. ^

It is essential to note that services rendered under a Medicare Treatment Plan are claimable through Medicare only. Once you have fully utilised your Treatment Plan, you may be eligible to use your private health insurance benefits for Psychology. Please reach out to Navy Health for more information regarding your benefits and waiting periods.

In summary, there are two scenarios where you might want to consider claiming for Psychology services through your private health insurance Extras cover:

Coverage Gap: If your mental health disorder cannot be addressed under the GP-Referred Treatment Plan, our Extras products can provide essential coverage.

Exhausted Sessions: In cases where you have already used up your 10 sessions for the year under your GP-referred Mental Health Treatment Plan, our Extras products could continue to support your mental health journey.

Under Psychology, you may also claim for hypnotherapy sessions. Hypnotherapy may help by tapping into your subconscious mind, allowing you to address and potentially reframe negative thought patterns, reduce stress and anxiety, and improve overall wellbeing. It could be a valuable tool for managing conditions like phobias, insomnia, and even certain forms of addiction. Hypnotherapy is claimable under Premium Extras and Healthy Living Extras products. ^

^Set benefits, sub limits, waiting periods, and pre-existing conditions may apply. View the Important information about your policy document for more information.

Your Hospital Cover

For Premium Gold Hospital covered members who have served their two month waiting periods, Navy Health could help pay towards hospital psychiatric services in a private hospital. This may help cover some of the costs of hospital accommodation and some medical costs raised by doctors where a Medicare benefit is payable.

The Mental Health Waiver

The Mental Health Waiver allows members with limited hospital cover immediate access to private psychiatric care without needing to serve the usual 2 month waiting period. It allows members who have served their two-month waiting period for restricted hospital psychiatric services to upgrade to a Gold Hospital cover which includes hospital psychiatric services and elect to have the two month waiting periods waived.

This means that individuals can seek mental healthcare and services without having to wait for an extended period of time after obtaining their insurance coverage.

In order to be eligible to access the Mental Health Waiver, you need to have held any eligible private hospital cover for a full two months.  If you have held Hospital cover for less than two months, you will need to complete this waiting period before the Waiver becomes available.

If you are restarting your cover or transferring between health insurance funds and have been without hospital cover for more than 30 days, you will need to re-serve the initial two-month hospital waiting period before the Mental Health Waiver becomes available to you.

The Mental Health Waiver applies to everyone listed on your health insurance policy, and each eligible person can use it once in their lifetime. This means that if you have multiple individuals covered by the same policy, each of them can access the Mental Health Waiver for psychiatric care once during their lifetime.

Contact our Member Services Team

If you are still unsure about how your policy may be able to assist you with mental health services, please call our Member Services team on 1300 306 289, or email query@navyhealth.com.au.