Why Counsellors Can’t Use Mental Health Care Plans in Australia, And Why That Isn’t Always a Bad Thing
Many Australians have heard of a Mental Health Care Plan, often called an MHCP. The current Medicare wording is usually Mental Health Treatment Plan, but many people still use the older phrase in everyday conversation.
A Mental Health Treatment Plan can be helpful. It allows eligible people to claim Medicare rebates for a limited number of sessions with specific mental health professionals. Under the Australian Government’s Better Access initiative, eligible services can be provided by GPs, prescribed medical practitioners, clinical psychologists, registered psychologists, eligible social workers and eligible occupational therapists. Counsellors are not currently listed as eligible private practice providers under this Medicare rebate pathway.
That can feel confusing, especially when many counsellors are qualified, experienced, registered, insured and highly skilled in providing mental health and wellbeing support. So, why can’t counsellors access Mental Health Care Plans?
Why counsellors cannot currently offer Medicare rebates under MHCPs
The simple answer is that Medicare rebates are tied to specific Medicare Benefits Schedule rules. Under Better Access, Services Australia lists the eligible allied health professionals as clinical psychologists, registered psychologists, occupational therapists and social workers.
This does not mean counselling is not valuable. It means counsellors are not currently included in this particular Medicare funding pathway.
Many professional counsellors in Australia are registered with PACFA, the Psychotherapy and Counselling Federation of Australia. PACFA sets professional standards for counselling and psychotherapy, including training, ethical practice, supervision and ongoing professional development. So, while counsellors are not currently included under the Medicare Mental Health Treatment Plan rebate system, this does not mean they are unqualified or unregulated. Many counsellors are highly trained, professionally registered, insured and experienced in supporting people with mental health, relationships, stress, grief, workplace challenges and overall wellbeing.
In other words, the issue is not that counselling “doesn’t count”. It is that Medicare has its own eligibility rules, and those rules have not yet fully caught up with the counselling profession.
A little frustrating? Absolutely.
Very Australian health system? Also yes.
What a Mental Health Treatment Plan involves
To get a Mental Health Treatment Plan, you generally need to book an appointment with your GP. Healthdirect advises asking for a longer appointment so there is enough time to discuss your mental health. Your doctor will assess your mental health, may use a questionnaire, discuss your goals and provide a referral if a plan is appropriate.
A plan can allow you to claim up to 10 individual and 10 group mental health sessions per calendar year through Medicare, although the first referral is usually for up to 6 sessions before a review is needed.
This pathway can be helpful for many people. However, it is not the only way to access support.
The benefits of seeing a counsellor without a Mental Health Care Plan
1. You do not need to see a GP first
One of the biggest benefits of private counselling is ease of access. You can book directly with the counselling service without needing a GP appointment, a referral, or a formal Mental Health Treatment Plan.
For some people, this removes a major barrier. Not everyone feels ready to speak with a doctor about their mental health. Others may not want to wait for a GP appointment before starting support. Private counselling can allow people to reach out earlier, before stress, anxiety, relationship strain or burnout become harder to manage.
2. You do not need a formal mental health diagnosis
Private counselling can be useful for people who want support but may not see themselves as “unwell” or needing a diagnosis. Many people come to counselling for reasons such as:
- Relationship difficulties
- Work stress
- Life transitions
- Grief and loss
- Anger or emotional regulation
- Parenting stress
- Communication issues
- Self-esteem
- Burnout prevention
- General wellbeing
You do not need to wait until things feel severe enough to fit a medical pathway. Counselling can be proactive, practical and preventative.
3. There is no Medicare claim attached to your counselling
When you use Medicare, there is a Medicare claim history. Services Australia notes that people can view Medicare Claims History Statements and Care Plan History Statements.
If you attend private counselling without using Medicare, there is no Medicare rebate claim for that session. This does not mean there are no records at all, as counsellors still keep confidential clinical records in line with professional and legal responsibilities. However, it does mean your counselling is not part of a Medicare Mental Health Treatment Plan claiming process.
For people who value privacy or simply do not want a mental health plan sitting within their medical pathway, this can feel more comfortable.
4. You can choose your own counsellor
Therapeutic fit matters. A lot.
Some people want a counsellor who is direct and practical. Others want someone warm and gentle. Some want support from someone experienced in couples counselling, men’s mental health, anger, anxiety, workplace stress or life transitions.
Private counselling gives you more freedom to choose the person you feel comfortable with, rather than being limited by referral availability, Medicare item eligibility or who has appointments under a rebate model.
The relationship between client and therapist is one of the most important parts of therapy. If the fit is right, people are often more likely to engage, open up and keep attending.
5. You are not limited to 10 Medicare-rebated sessions
A Mental Health Treatment Plan can provide rebates for up to 10 individual sessions per calendar year.
For some people, 10 sessions are enough. For others, it may not be. Counselling without Medicare does not have the same annual cap on sessions. You and your counsellor can decide together what support looks like, how often you attend and when it feels right to pause or finish.
That flexibility can be especially helpful for long-term personal growth, relationship work, complex life stress, grief or recurring patterns that need more time and care.
6. Counselling may suit people who do not want a medical model
The Medicare pathway is important, but it is still a medical pathway. It usually involves assessment, diagnosis, referral, treatment planning and review.
Counselling can offer a different feel. It can be less about “what is wrong with me?” and more about “what is happening in my life, how is it affecting me, and what can we do about it?”
This can make counselling feel more approachable for people who are hesitant about therapy, worried about labels, or simply looking for practical support.
7. It can be easier for couples and relationship support
Mental Health Treatment Plans are generally designed around individual mental health treatment. Healthdirect notes that Medicare group therapy under a mental health treatment plan does not include family and couples therapy.
Private counselling can be a better fit when the focus is relationship-based, such as communication, trust, conflict, separation decisions, parenting tension or rebuilding connection.
8. Private health rebates may be available
Medicare is not the only possible rebate pathway. Some counsellors may be recognised by private health funds, depending on their registration, provider status and the client’s extras cover. PACFA advises that clients with private health insurance extras may be able to claim benefits for counselling and psychotherapy services, but they need to check directly with their health fund.
This will not apply to everyone, but it is worth checking.
Is a Mental Health Care Plan still worth considering?
Yes, it can be.
A Mental Health Treatment Plan may be useful if you want Medicare rebates, need psychological treatment, want your GP involved in your care, or have symptoms that would benefit from a more medical or diagnostic pathway.
It is also important to remember that a Medicare rebate does not always mean the session is free. The Australian Psychological Society notes that psychological therapy sessions often cost more than the Medicare rebate, meaning people may still pay an out-of-pocket gap unless the psychologist chooses to bulk bill.
So the best pathway depends on your situation, budget, goals, privacy preferences and the type of support you are looking for.
What about newer Medicare mental health services?
Australia is also developing newer mental health access pathways. Medicare Mental Health says its services can connect people with support, and that people do not need a referral or Mental Health Treatment Plan to use those services.
That is separate from seeing a private counsellor under a Mental Health Care Plan, but it does show an important shift: people often need easier access to support without too many hoops to jump through.
The bottom line
Counsellors cannot currently provide Medicare-rebated sessions under a standard Mental Health Care Plan because they are not included in the eligible Better Access provider list.
But counselling without a Mental Health Care Plan can still be a strong, accessible and flexible option. It can allow you to choose your own counsellor, avoid waiting for a GP appointment, access support without needing a formal diagnosis and work on concerns that may not neatly fit into a medical model.
Medicare-supported care has an important place.
So does private counselling.
The right option is the one that helps you access support in a way that feels safe, practical and useful for you.
Watkins Therapy Group provides counselling support for individuals, couples and workplaces, with in-person appointments in Frankston, Mt Eliza and McCrae, and telehealth or phone appointments available Australia-wide.
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