Medicare: FAQ

Medicare

How Does The Medicare System Work?

Under the Medicare system a client must be referred by a GP or Psychiatrist. Your medical practitioner will need to complete and prepare a Mental Health Care Plan and supply a valid refferal letter to your psychologist, dated prior to your first session, in order for you to claim a Medicare rebate for that session. Eligible clients can then claim a partial rebate for the cost of their session from Medicare. This can be claimed up to a maximum of 10 sessions per calendar year. After the sixth session, your psychologist will provide a report to your referring medical practitioner.

You must return to your Medical Practitioner for a re-refferal letter after six sessions with your psychologist. Your Medical Practitioner will assess whether it is appropriate for you to access further sessions under a Medicare related referral. Without the re-refferal letter any claim made to Medicare will not be processed.

How Do I Obtain A Mental Health Care Plan?

You need to book an appointment with your GP to discuss your eligibility for a Mental Health Care Plan. Most GP's will require you to book a long consultation to allow adequate time to co-ordinate the Mental Health Care Plan and discuss treatment options. Please speak with your own GP practice as to their booking requirements.

After the plan has been prepared, Relate Psychology must receive a signed letter of referral from the GP which specifies the number of sessions you are referred for. A copy of the Mental Health Care Treatment Plan without the referral letter does not constitute a valid referral.

Please make sure your Medical Practitioner supplies a refferal letter that contains the following:

date
your name, date of birth and address
diagnosis / problem
request for services and number of sessions (maximum number of sessions per refferal letter is 6)
referring practitioner’s Medicare Provider Number
practitioner’s signature
a statement that specifies you have a MHCP but one does not need to be supplied

Can I Claim Relationship Counselling Through Medicare?

The Medicare rebates offered with Mental Health Care Plans are for the treatment of individual clients only, as such, relationship counselling is not claimable through Medicare. In some instances, it might be helpful for your partner to accompany you to a session, but they would be there as a support only.

When clients have a Mental Health Care Plan, the individual named on the plan is my client. In relationship counselling, the relationship, as opposed to the individuals, becomes my client. Most private health insurers, however, cover relationship counselling with a psychologist.

IF I NEED MORE THAN 10 SESSIONS WITH MY PSYCHOLOGIST CAN I CLAIM ADDITIONAL SESSIONS THROUGH MEDICARE?

Medicare rebates are payable up to a maximum of 10 individual sessions per calendar year. If you do require additional sessions with your psychologist, no further Medicare rebates can be claimed. You may be able to make a claim for further psychology sessions if you are a private health fund member. Please check eligibility with your private health fund provider.

I HAVE BEEN SEEING ANOTHER PSYCHOLOGIST BUT WOULD LIKE TO CHANGE TO RELATE PSYCHOLOGY. CAN I USE MY EXISTING PLAN?

Yes, if you still have sessions available for the calendar year. We do request a referral to Relate Psychology from your GP to accompany the existing plan. Please make sure that referral stipulates how many sessions you have had with the other psychologist. You may be asked to consult with your medical practitioner for a review of your existing plan if 6 sessions have already been used.

CAN I CLAIM A PSYCHOLOGY SESSION THROUGH BOTH MEDICARE AND PRIVATE HEALTH?

You cannot use your private health insurance cover to top up the Medicare rebates for psychological services. If you are eligible for Medicare rebates then you need to decide which service you will use to cover the payment for psychological services you receive.