Psychologists gap fees. Are they sustainable for health care card and pensioners? What needs to be done?

Hi @Mathew76 I'm on a concession card as well and on a DSP. I was put on a mental health care plan this year for the first time this year, which gave me 10 subsidised visits. Even then they bumped the gap fee from $32 to $50 during those 10 visits I had over 4 or 5 months. I had a couple recently with someone else and the fee is much higher for concession plus one of my 5 allied health visits, than concession plus mental health care plan visits. It was about 3 times as much.

So did they say in the $90 fee was for a concession only or concession plus MHCP? Did they even say what the problem was? I suppose the only thing you could do is contact the psychologist and get more information and/or contact the GP and ask them. The one I saw was cheaper than others, so it wouldn't shock me that $90 could be a gap fee for a psychologist visit even with a mental health care plan on a concession.

Hi @Mathew76

I used to work in admin in a psychology clinic and had a lot of experience talking to clients about mental health care plans, and I hope I can share some insight with you:

Something that I think is often not well explained is that most of the time your mental health care plan will only cover a portion of the cost of a psychology session - of course the price varies from each practice, but it generally covers about half the cost. Often practices or practitioners will offer a small discount for pension or concession card holders but from my experience this is often about 5-10%. This still leaves a gap fee.

The exception to this is bulk-billing practitioners or practices, but unfortunately finding bulk-billing services can be very challenging as

1. They get booked out fast and have a high demand,

2. The rebate that the government offers is not sustainable for many practitioners who would need to take on more clients and extend themselves beyond their capacity to keep up with the business costs, which is ultimately no good for the practitioner or their clients. Some practitioners will take on a small amount of bulk-billed clients, but again, these often get filled quickly.

This may have been a bit of a ramble, I apparently have lots to say on this topic, but to answer the question of what should be done: On an individual level I'd encourage you to ask if your GP could assist you in finding a bulk billing clinic in your area, or one with lower fees. Or perhaps the psychology clinic you were referred to might be able to point you in the right direction? If you are open to it, I know that there are a range of online telehealth clinics that do offer bulk-billing.

And on a broader level the Medicare rebate amount is not sustainable for practitioners and needs to be increased so that more are able to offer bulk-billed services.

Hi @Mathew76,

Thank you for sharing what is such a frustrating reality for many of us who are just trying to find affordable support, even with a mental health care plan and 10 subsidised sessions it's still so difficult to manage.

Perhaps you could have a look on here for any nearby that do offer bulk-billing.

A good telehealth option is Better Place Australia, who offer affordable sessions.

There is Mind Australia's psychologist telehealth service, but there is a gap fee, and I'm not sure how much it is — but worth an ask.

There is also SANE's Support Line which you can contact on 1800 187 263 (Monday to Friday, 10am – 8pm (AEDT/AEST) and there is SANE's Guided Recovery which is a free (15-week) mental health recovery program.

Sorry, I hope that's not too overwhelming — I just wanted to provide you with some information about other potential options.

I hope that you find the support that you need.

Hope to hear from you soon, take care.

The annoying thing is that they (most) will always adjust their fees in response to Medicare subsidies. If the government increase their Medicare subsidies from previously covering $80 of a $200 fee to covering $100 of a $200 fee, (most of) the shrinks will just rub their hands in glee and start charging $240. They've figured out that a majority of the population can afford $X per session and adjust accordingly.

Medicare was designed to cover medical and then dental. However, since psychologists were an educated acquisitive lot like a lot of Australian small business opportunists, they jumped in and lobbied hard and got the subsidy and held it hard, its probably a reason Australians do not have Medicare covering dental. It is hard to value their services and having enablers certainly will not help people on concession cards with mental health plans get through their weeks if a psychologist cleans their food budget first. Yeah, you sure did drink the coo-laid.

Your response indicated you have an understanding of the issue and I appreciate that. So many people have no idea and live in bovine ignorance until it happens to them.

Far be it from me to wish human misery on anybody but I would like to see some of the psychologists reception staff experience what I have experienced.

I think we need to talk to local members, if they have a decent electoral office. Still next election and the need to punish Labor might mean we have no more medicare at all.

@Mathew76

Hearing you loud and clear.

I worked in welfare a long time ago and spent a long time paying a lot of gap fees. I don’t consider them fair or justified.