What are the changes to mental health benefits?

Changes were introduced on 1 April 2018 to improve patient access to mental health services

The Government introduced changes to make it easier for policy holders to access mental health services and drug and alcohol treatment when they need it. 

What does this mean?

Members on low-tier policies who have restricted access to mental health cover are being given the option of having their waiting periods waived if they want to upgrade their policy to access mental health services. Please note, policy holders are able to use this exemption from the usual waiting period on a once-off basis and the psychiatric care upgrade applies to the shared room accommodation benefit only. Limits on the number of mental health sessions or treatments a patient can access as a condition of their insurance policy were removed. Limits that were in place typically applied to day programs, electroconvulsive therapy and transcranial magnetic stimulation.

Why is this important?

Private mental health and drug and alcohol treatment services are highly valued by people, particularly younger people. However, most basic and medium level hospital products provided limited cover for these services. Patients with these products who require overnight or multi-day care in a private hospital for a serious mental health condition will usually face large out-of-pocket costs. Waiting periods for upgrading cover can prevent patients from accessing timely care. The once-off waiting period exemption will make it easier for patients to access care when they most need it, without facing substantial out-of-pocket costs. Removing limits on the number of mental health sessions or treatments a patient can access will improve patient access to care.

Who will benefit?

Patients with basic or medium level hospital cover products who have served the 2 month waiting period at a restricted levelwill benefit by being able to upgrade their cover and immediately access in-hospital mental health and drug and alcohol treatment services.

What impact will this change have on private health insurance?

These changes are very important for people at risk of mental illness, particularly younger people.

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