Detailed Information on GP Mental Health Plan offered by Medicare Australia

I am giving out this piece of information to help my readers to know in details how the GP Mental Health Plan works.

The information in this post is extracted from Australian Psychological Society website. The link to the complete post is

http://www.psychology.org.au/medicare/fact_sheet/

What is the Better Access to Mental Health Care initiative?

Medicare rebates are available for psychological treatment by registered psychologists under the Australian Government’s Better Access to Mental Health Care initiative. This scheme provides considerable assistance to people living with mental heath problems, allowing them greater access to psychologists and providing more affordable mental healthcare.

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What mental health problems can be treated under the Better Access initiative?

‘Mental disorder’ is a term used to describe a range of clinically diagnosable disorders that significantly impact on a person’s emotions, thoughts, social skills and decision-making. The Better Access initiative covers people with mental disorders arising from:

Can I go directly to a psychologist to receive treatment through Medicare?

You must be referred 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.

Can I access any psychologist?

Under the scheme you can only see a registered psychologist with a Medicare Provider Number who you have been referred to by your GP, psychiatrist or paediatrician.

Can I request a referral to a specific psychologist or does my doctor have to choose?

Your doctor must first assess that you require the services of a psychologist. Your doctor may allow you to request a specific psychologist or may refer you to a registered psychologist that he/she recommends. The psychologist in question must be registered and have a Medicare Provider Number for you to be able to claim the Medicare rebate.

If I am already seeing a psychologist, can I access Medicare benefits?

In order to receive a Medicare rebate, you must be referred to a psychologist by an appropriate medical practitioner (GP, psychiatrist or paediatrician). The doctor must first make an assessment that you need the services of a psychologist. If you are already seeing a psychologist, discuss this with your doctor.

How many sessions with a psychologist am I entitled to?

Eligible people can generally receive:

Up to 12 individual services in a calendar year. Your referring doctor will assess your progress after the first six sessions.

Up to 12 group therapy services in a calendar year where such services are available and seen as appropriate by your referring doctor and the psychologist.

What will it cost me?

The cost to you will vary depending on the length of the session and the fee being charged by the psychologist.

If the psychologist decides to bulk bill then you will not have to pay anything.

However, if the psychologist does not bulk bill then you must pay the difference between what the psychologist charges you (a fee set by the psychologist) and the Medicare rebate. This will vary and you should check this with the psychologist before commencing your treatment.

Readers may note that in my practice bulk billing is available. That means my clients who are referred through GP Mental Health Plan DO NOT NEED TO PAY ANYTHING.

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.

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