Access via Medicare & Private Health Insurance

At Ability, we offer psychology services under Medicare or Private Health Insurance in-clinic (North Lakes) or online by telehealth. In order to access services under Medicare, a valid Mental Health Care Plan must be acquired via your GP in advance of engagement. When a valid Mental Health Care Plan has been obtained,  a rebate is available for psychological treatment under Medicare of $96.65 (as at July, 2024) for up to 10 sessions and the remaining gap fee is payable by the individual for each session. Due to the costs associated with running a private practice, unfortunately we are unable to offer bulk-billed services. To be referred for support under a Mental Health Care Plan, make an appointment with your General Practitioner (GP) for further advice and referral. Please consider making a 'long' appointment with your GP (if given the option) to allow sufficient time for them to complete this process with you.   

It is also relevant to note that Medicare does not cover assessment or disability services as a Mental Health Care Plan pertains to focused psychological therapies. Medicare prohibits the use of funding towards NDIS services. For example, treatment for 'disability' without psychopathology is specifically precluded and considerable penalties can apply. Due to this, services cannot be shared between both schemes interchangeably. In the same way that the NDIS services preclude the use of funding for supports more appropriately funded by the health system (i.e., treatment), Medicare precludes the use of funding for services that are more appropriately funded by the NDIS (e.g., capacity building and disability-related support). 

With regard to Private Health Insurance, we recommend speaking with your insurer and deferring to their PDS to determine your coverage for psychological therapies (typically listed as an 'extra' in coverage). If approved, a Private Health Insurer will typically cover a percentage of your session fee and a gap fee will remain payable. Unfortunately you cannot use your private health insurance ancillary cover to top up the Medicare rebates for clinical services. This is because Medicare stipulates that an individual must decide if they will use Medicare or their private health insurance ancillary cover to pay for psychological services they receive. As noted above, psychology is a service that can be included in the extras cover of Private Health Insurance (unlike psychiatry, which is usually covered under hospital cover) however this will depend on your level of coverage. There are likely to be annual limits that apply. To find out more, please consult the Product Disclosure Statement (PDS) or your Private Health Insurer