Understanding therapy rebates

Rebates are one of the more confusing parts of starting therapy, mostly because “rebate” gets used loosely to mean a few different things.

What Medicare covers

Under a Mental Health Care Plan, Medicare rebates part of the fee for sessions with a registered provider — a set dollar amount per session, not a percentage. You pay the provider’s fee upfront (unless they bulk-bill), and the rebate either comes back to you afterward or is deducted on the spot, depending on how the practice processes claims.

What it doesn’t cover

The rebate amount is fixed regardless of what a provider actually charges, so if their fee is above the rebate, you’re paying the difference — the “gap.” Providers set their own fees, so this gap varies a lot between practices. Private health insurance extras cover is separate from Medicare and works differently again — check your own policy rather than assuming it stacks with a Medicare rebate for the same session.

Questions worth asking before your first session

• What’s the session fee, and what’s the gap after the Medicare rebate?
• Do they bulk-bill, and if so, under what circumstances?
• Do they process the Medicare claim for you, or do you need to claim it separately?

None of this affects the quality of the support you get — it’s just worth knowing upfront so a bill doesn’t catch you off guard.