Claiming Mental Health Treatment with Westfund in 2024

As a national, member-owned private health insurer operating since 1881, Westfund is dedicated to providing support to improve its members' health and well-being. Supporting the mental health of its members is a key part of Westfund's offering.

If you are looking to commence therapy with a psychologist and you have Westfund insurance, the cost of your therapy may be covered by your plan. This comprehensive Westfund health insurance guide will help you understand whether you can claim Westfund psychology support.

Table of contents

• Do Westfund extras cover online psychology?

• What's covered by Westfund?

• Which Westfund policy covers psychology rebates?

• How much is the Westfund psychology claim?

• How do I use Westfund extras to claim the cost back of psychology?

• When do I need to make a claim?

• Can I claim a psychologist fee on Westfund and Medicare?

• Where can I find Westfund approved therapists?

• Easily claim Westfund psychology rebates with Talked

Do Westfund extras cover online psychology?

Westfund offers psychology coverage for its members, including both in-person sessions and online consultations. Recognising the need for flexible access to psychological services, Westfund ensures that members can receive support wherever and whenever needed.

However, it's important to verify if these psychology sessions are included in your extras cover before making a claim. This can be done easily by logging into your Westfund account.

What's covered by Westfund?

To have your psychology session partially or fully covered by Westfund, the psychologist must meet their approval criteria and be a registered provider. Simply booking any therapist won’t guarantee you can claim the cost back, even if your policy includes this service.

For example, Westfund only accepts claims for online psychology services provided by Medicare rebateable psychologists and social workers, and counsellors registered with the Australian Regional Health Group. If you’re unclear about the differences between these professionals, our blog post breaks down the distinctions.

Westfund is explicit in that they will cover mental health under the category "Clinical Psychology" or "Clinical Psychology & Counselling". Clinical Psychology does not mean that you only can see clinical psychologists and not general psychologists (learn about the differences in our comparison article). Westfund will still cover psychology sessions with a general psychologist as long as they meet Westfund's provider criteria. For counsellors, they will need to have the appropriate registration.

It’s also essential to confirm that your Westfund plan includes coverage for psychology. Not all extras policies offer this, so it’s worth verifying whether your policy includes "Clinical Psychology" or "Clinical Psychology & Counselling". You can log in to your Westfund account using the link below to check.

Check my Westfund cover

Thankfully, using Talked to find a Westfund approved psychologist takes the confusion out of finding a complying therapist. By booking with one of these qualified online psychologists on Talked, you’ll be eligible to claim the session cost through your Westfund extras cover. We’ll walk you through the process shortly.

Which Westfund policy covers psychology rebates?

It's important to understand whether your Westfund health insurance policy allows you to claim clinical psychology sessions. If you are unsure, there's no need to worry as we can help. Westfund states on their mental health support page that they cover Clinical Psychology in their extras policies.

The current Westfund extras that explicitly cover clinical psychology rebates are:

• Starter Extras

• Choice Extras

• Mid Extras

• High Extras Over 50s

• High Extras

• Ultimate Extras

The current Westfund extras that cover both clinical psychology and counselling are:

• Choice Extras

• High Extras

• Ultimate Extras

As of the date of this article, there are no Westfund extras packages that do not also cover Clinical Psychology. However, not all Westfund policies also include counselling under the "Clinical Psychology & Counselling" tab. On the plus side, this means that whatever extras cover policy you choose, you will gain access to psychology cover.

However, when seeking Westfun extras cover for psychology rebates, it's crucial to verify that the policy details continue to include "Clinical Psychology" or "Clinical Psychology & Counselling". If you have a policy that supports Westfund psychology and|or counselling, understanding the amount covered under the annual limit is just as important.

How much is the Westfund psychology claim?

The amount you can claim back through your Westfund extras cover depends on the details of your policy. We strongly encourage you to review the full disclosure PDF for your cover to understand how your policy works. You can do this by logging into your Westfund account.

When choosing your Westfund extras cover, we recommend you look at the following:

Waiting Period – Westfund's extras policies generally include a waiting period, which is a set amount of time during which you cannot claim benefits for any treatments. Currently, Westfund imposes a two-month waiting period before members can claim rebates for psychology services. If you’re considering joining Westfund, note that they have previously run promotions waiving this waiting period.

Item Limit – The Item Limit refers to the maximum benefit amount payable for a specific service or treatment within a calendar year. This limit determines the highest amount Westfund will reimburse for a particular item number associated with a health service. Under Westfund policies, this can range from $20 per service to $100 per service.

Annual Group Limit – The Annual Group Limit is the maximum total benefit amount payable for a specific category or group of related services within a calendar year. This limit caps the combined reimbursements you can receive for all services within that group during the year. Westfund often breaks this down in their extras policies as on a Single or Couple|Family basis.

The table below sets out in detail, as of the time of this article, the amount that Westfund covers under their current extras packages.

*Combined limit for Other Therapies, Health Management and Preventative Health.

How do I use Westfund extras to claim the cost back of psychology?

When booking your Westfund psychology session on Talked, you will need to pay for it upfront. After your session is completed, we will provide you with an invoice that you can use to claim your session costs from Westfund.

To access your invoice through Talked, simply login to your account and download it. We ensure the invoice is automatically populated with all the necessary details required by Westfund to process your claim smoothly.

There are 3 ways that you can make your Westfundpsychology claim after speaking with a Talked psychologist.

1. Use the Westfund mobile app

If you book a psychology or counselling session, you can claim by taking a photo or screenshot of the receipt or invoice. To be eligible to claim a Westfund rebatable session, the details that Westfund often require to process a rebate are:

• Patient’s name

• Provider’s name and number

• Date of service

• Service provided

• Amount paid

After obtaining the receipt with all the required details, submit your claim through the Westfund mobile app. Open the app, photograph your receipt, attach any relevant supporting documents, and press submit.

If you book a therapist through the Talked platform, you can easily log in to your account and download the invoice. The invoice is automatically filled with the exact information Westfund requires, including the therapist's provider number.

Download the Westfund mobile app for iPhone or Android.

2. Claim through Members Online

Westfund's Members Online portal makes it easy for you to lodge a claim online. Either sign in or register for Members Online and lodge your claim. From there you can upload your invoice and click submit.

3. Email

Lastly, you can email your completed claim form along with your receipts or invoice to Westfund at claims@westfund.com.au.

We’d also like to note that if you are not seeing a psychologist through Talked and are visiting your psychologist in person, you may be able to swipe your membership card at the psychologist’s HICAPS machine. This allows you to pay only the difference between the psychologist’s fee and the Westfund coverage, eliminating the need to pay the full amount upfront.

When do I need to make a claim?

To claim your psychology or counselling rebate from Westfund, we recommend that all members submit their claims as soon as possible after their session. While immediate submission is ideal, Westfund allows claims to be lodged up to two years from the date of your psychology session. However, this policy is subject to change, so it’s important to confirm the current guidelines with Westfund.

Similarly, Medicare permits claims to be submitted within two years of the session date. Unlike Westfund, however, Talked can process Medicare rebates on your behalf, making the process even simpler. For more information, visit our Medicare page.

Can I claim a psychologist fee on Westfund and Medicare?

Unfortunately, Westfund does not permit simultaneous claims for psychology sessions alongside Medicare. If you plan to claim the Medicare rebate for your psychology sessions, you’ll need to wait until you’ve used all your yearly Medicare-entitled sessions before submitting a claim with Westfund.

To determine if you’re eligible for a Medicare rebate, consult your GP. The process can be a bit complex, but you can refer to our detailed article on Medicare for guidance. Keep in mind that even with Medicare claims, you may still need to pay a gap fee, depending on the psychologist’s charges.

Where can I find Westfund approved therapists?

Finding a psychologist covered by Westfund is simple with Talked. Browse our extensive list of Westfund approved psychologists, book a session within 24 hours, and connect with your chosen therapist through our secure telehealth platform.

Easily claim Westfund psychology rebates with Talked

As highlighted in this article, Westfund is committed to supporting its members' mental health by offering rebates for psychology sessions. Talked makes it easy to claim your Westfund psychology rebate with just a few clicks. After your session with a Westfund approved psychologist, you’ll receive an invoice pre-filled with all the required details to facilitate your rebate claim.

Not with Peoplecare? Don't worry, we have your back. After you see your therapist, claim your mental health rebate from Bupa, ahm, Medibank, Police Health, CUA Health, Doctors Health, nib, HBF, HCF, CBHS Health, Australian Unity, GMHBA, Peoplecare and many more private health insurers.