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Private Health Funds

Private Health Funds

The AASW continues to advocate for the inclusion of Accredited Mental Health Social Workers (AMHSWs) in all private health funds.

NEWS…

  • The Australian Regional Health Group (ARHG) has added Accredited Mental Health Social Workers to its Ancillary Provider Accreditation Service, following the ARHG accreditation of the AASW on 1 September 2024. This arrangement will enable more private health funds to recognise and pay benefits for mental health services provided by AMHSWs. 
  • From 1 July 2024, St Lukes Health now recognises AMHSWs as providers of mental health services for their members to claim benefits under Extras cover that includes mental wellness.
  • From 1 July 2023, HCF recognises AMHSWs as providers of mental health services for their members to claim benefits under eligible Extras cover.
  • From 1 August 2023, an item schedule for AMHSWs takes effect after its endorsement by Private Healthcare Australia (PHA). This endorsement has enabled HICAPS to include AMHSWs on their claims processing terminals. 

AMHSWs are highly skilled and regulated private practitioners who hold Medicare Provider Numbers and are eligible for rebates from Medicare for clinical mental health services, such as the Australian Government’s Better Access to Mental Health Care program.

AMHSWs are not included as ‘Ancillary Providers’ by most Australian private health funds. The AASW asserts that the current situation places AMHSWs at a competitive disadvantage and many consumers at a financial disadvantage in terms of receiving assistance for mental health issues.

Thanks to the advocacy work of the AASW, AMHSWs are now included under:

  • HCF
  • Bupa
  • Teachers Health Fund
  • Doctors Health
  • St Lukes Health
  • Australian Regional Health Group Ancillary Provider Accreditation Service 

We are continuing our efforts to have AMHSWs included in more private health funds as eligible providers of mental health services. 

AMHSWs are not included in the list of allied health providers who are identified by several Australian private health funds (except Teachers Health Fund and more recently Bupa and HCF) as ‘Ancillary Providers’. This means that consumers who are insured for ‘extras’ are not able to claim against their insurance for services provided by Accredited Mental Health Social Workers.

AMHSWs are regulated private practitioners who hold Medicare Provider Numbers and are eligible for rebates from Medicare for clinical mental health services, such as the Australian Government’s Better Access to Mental Health Care program. AMHSWs are accredited members of the AASW and represent one of the highest standards in professional recognition. They are subject to the same accreditation requirements as both their registered and self-regulated allied health counterparts, such as psychologists, physiotherapists, dietitians and speech pathologists, in adhering to professional and ethical standards, maintaining Continuing Professional Development and engaging in professional supervision.

In order to achieve AMHSW accreditation, social workers must be able to demonstrate:

  • appropriate use of evidence-based interventions
  • integrating concepts of recovery into practice
  • utilising a psychosocial assessment and formulation addressing physical, psychological and social aspects of the person and their situation and
  • basing interventions on the best evidence available.

 

The AASW asserts that the current situation places AMHSWs at a competitive disadvantage and many consumers at a disadvantage both financially and in terms of receiving assistance for mental health issues.

Without a change in the current situation, consumer choice in accessing health care is significantly limited.

The AASW is engaged in continuous advocacy action with private health providers calling for immediate change. As we are engaging with individual providers separately, there has been varied progress.

We have also raised this issue in the appropriate federal forums. We will continue to update members as any new information becomes available.

We encourage all AASW members who have private health insurance to write to their provider and request that they include Accredited Mental Health Social Workers.