Mental health
Everyone’s experience with mental health is different. We’re here to help you understand your cover options.
Does private health insurance cover mental health services?
Australia’s health system offers a mix of public, Medicare‑funded care and private health insurance options. Depending on your cover, private health insurance can help with the costs of some mental health services, both in and out of hospital.
If you need help understanding your mental health cover options—whether it’s psychology support, inpatient psychiatric cover, or hospital and extras cover - please get in touch.
- May pay benefits for inpatient psychiatric services (restricted on some policies).
- Eligible GMHBA members with hospital psychiatric cover can access the WellBeing4Life program.
- Can pay benefits towards psychology and mental health services with a counsellor, mental health social worker or nurse - available in person or via telehealth. If you have a Mental Health Treatment Plan through your GP, Medicare-subsidised sessions must be used first.
- Benefits, limits and waiting periods vary - check your fact sheet or the GMHBA app or member area.
How Medicare & private health insurance works
If you’re a public patient in a public hospital, Medicare covers clinically necessary care and accommodation. However, availability is assessed based on urgency and availability, which can limit choice, when and where care is provided.
Medicare also supports out-of-hospital mental health services. Eligible Australians can claim rebates for up to 10 individual and 10 group sessions with an eligible mental health professional, each calendar year under a Mental Health Treatment Plan - through the Better Access initiative.
While Medicare plays an important role in subsidising and providing access to mental health care in Australia, benefits are generally limited. If you reach your Medicate-rebated session limit for the calendar year or are requiring private inpatient psychiatric care, this is where private health insurance can help. GMHBA's Gold Optimum Hospital is the only cover currently available with this inclusion.
^Pricing based on Single, aged 30 living in VIC earning $101,000 or less (Base Tier Australian Government Rebate) and excludes . Prices and displayed products can change if details vary.
Hospital cover for psychiatric services
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Gold Optimum Hospital
FROM$ 83 .95
Hospital Excess $750Peace of mind hospital cover for all clinical categories (no exclusions)-
No excess for children under 21
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Excess waiver for same day stays
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Single room guarantee – if you request a single room in a private hospital
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Hospital cover for psychiatric services
If you or a family member need hospital care for severe mental health issues, it’s important to understand your treatment options under private health insurance hospital cover.
Depending on the level of cover, you may be able to access hospital care for mental health, addiction or behavioural conditions (hospital psychiatric services). A 2‑month waiting period applies, though a once‑in‑a‑lifetime waiver may be available.
Inpatient psychiatric care in a private hospital is covered under policies that include hospital psychiatric services. For new or upgrading members, this is only available on Gold Optimum Hospital.
Hospital psychiatric services are restricted on lower levels of GMHBA hospital cover, meaning lower levels of cover may only provide restricted benefits for public hospitals. Choosing private treatment without full cover can result in significant out‑of‑pocket costs.
Mental Health Waiver
The Mental Health Waiver allows eligible members who have served the 2-month waiting period for restricted psychiatric services, to upgrade their hospital cover to include inpatient psychiatric treatment in a private mental health facility and access benefits immediately.
Eligibility:
- Held hospital cover with restricted psychiatric services for at least 2 months
- Have not used the waiver before - available once per lifetime, per person
If you add other services when upgrading, standard waiting periods still apply to those services.
In partnership with Mind Australia, GMHBA offers additional mental health and wellbeing programs to support eligible members on their path to wellness and independence.
Health insurance for mental health FAQs
Restricted categories help keep health insurance premiums more affordable.
For restricted services, benefits are limited to the minimum (default) benefit as set by the Australian Government, which covers accommodation as a private patient in a shared room of a public hospital. The benefit does not cover the cost of a private room in a public hospital or any room in a private hospital, and does not cover theatre costs. If you are admitted to a private hospital for treatment that is restricted by your policy, large out-of-pocket expenses will apply.
Yes, waiting periods typically apply for mental health services.
Hospital cover - 2 month waiting periods typically apply for psychiatric services
Extras cover - 2 month waiting periods apply for psychology and mental health support services .
The mental health waiver is a once‑per‑lifetime option that may allow members to upgrade their hospital cover for mental health treatment and bypass the usual 2‑month waiting period. It only applies to hospital psychiatric care and not to extras or outpatient services.
The mental health waiver allows members who have served their 2-month waiting period for restricted psychiatric benefits to upgrade their hospital cover to include inpatient psychiatric treatment without serving an additional 2 month waiting period. The waiver applies only to the 2-month waiting period for in-hospital psychiatric treatment. Waiting periods for any other newly included services will still need to be served. Members can use the Mental Health Waiver once in their lifetime.
You can review your fact sheet – located in your member area or the GMHBA app, or alternatively contact us