Can I Claim a Rebate for Counselling?

by Oct 27, 2022

In Australia, the first step many people take towards therapy is to visit their doctor (GP). After conducting a mental health assessment, if the GP determines that you likely have a mental health disorder, they will likely write up a Mental Health Treatment Plan (MHTP) and refer you to a Psychologist or an Accredited Mental Health Social Worker. The MHTP will allow you to access Medicare rebates for 6-12 sessions per year.

Registered Counsellors are not part of the Medicare scheme.

Medicare-Subsidised Therapy

Some Medicare-funded therapists offer bulk-billed sessions, meaning there is no gap fee for a limited number of appointments. If so, they typically have a long waitlist, which is hardly surprising. Who doesn’t want “free therapy,” right? Most Medicare-funded therapists, however, charge a higher fee above the Medicare rebate, leaving a gap fee payable by you. This gap fee may be significant.

  • The recommended fee set by the Australian Psychological Society for a 46-60 minute session is $267. The Medicare rebate is $88 for a regular psychologist or $130 for a clinical psychologist, leaving a gap fee of up to $179.
  • The recommended fee set by the Australian Association of Social Workers is $240/hour. The Medicare rebate is $80, leaving you up to $160 per session out of pocket.

Once you’ve finished the year’s 6-12 rebated sessions, you will need to pay the therapist’s full fee.

The gap fee for Medicare-funded sessions counts towards your Medicare Safety Net; however, you will pay the therapist’s full fee once you’ve finished the allowed number of rebated sessions for the year. These non-funded sessions don’t contribute to your Safety Net. After the initial six sessions, the therapist writes a report to your GP, who will decide if additional sessions are needed.

Only a limited number of “Focused Psychological Strategies” are approved for Medicare-funded therapy. This includes approaches such as Cognitive Behaviour Therapy, Psycho-Education, Relaxation Strategies, skills training, interpersonal therapy, and EMDR. Note: Medicare rebates can not be used for couples counselling.

Advantages of Therapy Without Medicare Rebates

There are some benefits of not obtaining mental health treatment through the Medicare system:

  • You won’t have a mental health record on your Medicare file. (A MHTP becomes a permanent part of your health records, which may impact health and life insurance coverage and employment opportunities). Your diagnoses and management plan may be available to insurers and employers in some instances.
  • There is no limit to the number of funded or partially-funded sessions you can use in a calendar year.
  • The absence of medical records, reporting to your GP, and time limits to funding can create a more trauma-informed therapeutic relationship, which is the key factor in successful therapy.
  • You can choose the therapist of your choice rather than being limited by those with a Medicare Provider Number.
  • Depending on the fees charged by the Medicare-funded therapist, medicare-free therapy may become cheaper over time. The full fee is payable when the 6-12 Medicare rebates end. If the Medicare-funded therapist’s full fee is higher than that of a non-Medicare therapist such as a counsellor, it may be more frugal to see the counsellor from the beginning.
  • Counselling and psychology are not the same – which is best suited to your needs?

Counselling as a Viable Alternative

Counsellors are well-equipped to work with mental health problems. Our training is not aligned with the medical model, and we typically work from a non-pathological perspective. Although you cannot claim a Medicare rebate for counselling sessions, you may decide you don’t want to.

Counselling is, at its heart, a person-centred, holistic approach to therapy. Working with your emotions, relationships and life experiences, a counsellor comes alongside you in a way that prioritises your role in the therapeutic relationship. It is not an “expert”-based approach. You are the expert in your life, and as your counsellor, my goal is to use my training and lived-experience to provide a safe container in which you can connect to your internal resources, learn new ways of coping that work for you, and heal from the inside out.

If you have a health insurance policy that covers you for “extras”, you may find you can claim a rebate for counselling with me. I have a provider number for the following companies: Bupa, Medibank, ahm, Doctors Health Fund, Police Health Fund, St Lukes Health, Phoenix Health, Emergency Services Health, and Grand United. You will need to check with your provider.

Another alternative to making therapy more affordable without Medicare rebates is the option of fortnightly sessions. This is not suitable for all clients and all issues, but it is something you may want to discuss with me. It can be s a way to make therapy with me more accessible for you.

Ultimately, it’s your choice, and that’s the most important thing. You are free to choose what works for you. What are your important deciding factors? For instance, you may choose to:

  • Wait for a bulk-billing psychologist or social worker and only see them for the allowable number of funded sessions
  • See a psychologist or social worker who charges a gap fee for a limited number of sessions and then pay their full fee after the rebated sessions are finished.
  • See a Registered Counsellor outside of the Medicare system.

The most important thing is making the right choice for you. Some people prioritise therapy and find a way to pay, even if no way is initially evident. You may decide it’s worth finding a way to pay for a therapist who specialises in your problem.

If you’re interested in booking a free introductory call to see if I’m the right therapist for you, you can do so via the button below. I’d love to hear from you.

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