Claiming mental health treatment with Phoenix Health Fund

Phoenix Health Fund is a not-for-profit insurance provider that has been supporting many Australian individuals and families for nearly 70 years. It’s one of the few providers in the country that is member-focused, reinvesting earnings into member benefits to continually improve its services and members’ wellbeing.

Along with hospital cover, many members also secure Extras cover to help reduce everyday wellbeing costs from things like dental, optical, and mental health services. If you’ve been meaning to use your Phoenix Health Fund for mental health, this guide will help you check your policy, find a psychologist, and easily make a claim after your appointment.

Table of contents

• Does Phoenix Health Fund Extras cover online psychology?

• What exactly does Phoenix Health cover under psychology?

• How much can you claim for psychology with a Phoenix Health Fund policy?

• How to claim psychology sessions with Phoenix Health Fund?

• When should you lodge your claim?

• Can you claim the same session through both Phoenix Health and Medicare?

• How to find a Phoenix Health-recognised psychologist?

• Making Phoenix Health psychology claims simpler with Talked

Does Phoenix Health Fund Extras cover online psychology?

Yes, Phoenix Health Fund Extras, particularly the Value Extras 60, does cover both online as well as in-person psychology and counselling services.

To make sure that your sessions will be covered and your claiming process will be hassle-free, make sure to double-check which Extras policy you actually have and what benefits and limits come with it.

You can log in to Phoenix Health’s online portal to verify your cover.

What exactly does Phoenix Health Fund cover under psychology?

Only sessions with eligible mental health professionals are covered. In practical terms, this means:

• The provider is registered with the AHPRA as a psychologist

• The consult falls within Phoenix Health’s psychology service definition

• The session invoice meets the claim requirements set by the fund

Appointments with counsellors, provisional psychologists, or other coaches and therapists are often not claimable through Phoenix Health Extras. So to make things easier, it’s much better to go to a clinic or platform like Talked, where all psychologists are AHPRA-registered. 

According to Phoenix Fund’s most updated guidelines on Value Extras 60, members with this Extras can access a $200 sublimit per type of therapy and a $600 overall limit for all “Mindful Wellbeing” therapies every year.

The other Extras, such as the Kickstart Extras 50 and the Healthy Flex Extras 50, do not cover psychology.

➡️ ➡️ Browse AHRPA-registered psychologists here

How much can you claim for psychology with a Phoenix Health Fund policy?

Rebate amounts vary, but a Phoenix Health Value Extras 60 policy typically covers 60% of the full cost of your session. As such, the exact amount you’ll get back per session heavily depends on your psychologist’s fees.

Note that a psychologist’s rate also tends to differ between initial and subsequent consults. On Talked, however, you can access 15-minute initial consultations without any cost -- commitment-free -- and then book a full 50-minute session only when you're ready.

If you want to get an estimate of the amount you’ll get back from a session, you can log in on the Phoenix Health app and look for the feature that provides estimates.

How to claim psychology sessions with Phoenix Health Fund?

When you book a psychology session through Talked, you will be charged 48 hours before your appointment. After the session, Talked will provide you with a detailed invoice that includes all the information Phoenix Health typically requires, including:

• The patient’s name and full address

• The psychologist’s name and provider number

• Date and item number of the service

• Type and description of the provided service

• Amount paid

With your invoice ready, you can then submit your claim through any of the following methods:

1. Phoenix Health mobile app

Log in on your account via the Phoenix Health mobile app. Select between Fast Claims (rebate to be received the following business day) and Photo Claims (claim to be assessed within two business days), upload a photo or PDF of your Talked invoice, and submit instantly.

2. Online member services portal

Log in on the members’ portal, select the claim option, and upload your invoice.

3. Email or post

If you prefer, you can submit a completed claim form with the invoice attached via email address claims@phoenixhealthfund.com.au. Or, you can send through post: Phoenix Health Fund, PO Box 156 Newcastle NSW 2300.

For in-person psychology outside Talked, some clinics offer HICAPS claiming. This allows you to pay only the gap at the time of your appointment, provided your policy includes psychology.

When should you lodge your claim?

It’s best to lodge your claim immediately after your session. Doing so helps ensure the rebate falls within the correct benefit year and helps you receive your rebate more quickly.

Note that Phoenix Health Fund, like other insurance providers, have a waiting period for new and upgraded policies. Make sure that this waiting period has lapsed before using your policy for any treatment.

Can you claim the same session through both Phoenix Health and Medicare?

No, a single psychology session cannot be claimed from both a private health fund and Medicare at the same time. What you can do instead is use your Medicare rebate sessions first, then switch to private Extras once you’ve used up your Medicare allocation.

Note that a Mental Health Treatment Plan (MHTP) from a GP is required to access Medicare rebates. If you don’t already have one, Talked can connect you with our partner GP who can assess your eligibility and – if you’re eligible – issue an MHTP.

How to find a Phoenix Health-recognised psychologist?

Phoenix Health’s mantra in choosing any service provider is that your preferred provider is their preference too. So as long as your chosen psychologist is a registered provider (i.e., AHRPA-registered), then you’re good to go. 

On Talked, you can book any psychologist without worries because all providers on our platform have been carefully vetted. All of them are eligible for Phoenix Health- as well as Medicare-eligible sessions.

Making Phoenix Health psychology claims simpler with Talked

Phoenix Health Extras can make psychological care more accessible, and Talked ensures the claiming process will be hassle-free. After your appointment, you will receive a valid invoice ready to submit through the Phoenix Health app or portal. No guesswork, no delays.

If you are ready to begin, explore psychologists on Talked and choose the practitioner who best suits your needs.

Not with Phoenix Health? 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, Westfund, Peoplecare, GU Health, Union Health, Teachers Health, UniHealth, Nurses & Midwives Health, and many more private health insurers.