What the plan is
A Mental Health Care Plan — its formal Medicare name is a Mental Health Treatment Plan — is a document your GP prepares after assessing you. It records what you are dealing with, what the goals of treatment are, and who will provide it. Preparing it is a longer consultation than a standard appointment, so it is worth booking time for it.
Better Access, the Medicare program the plan sits inside, applies to people with a clinically diagnosed mental disorder, and the Department of Health directs that referrals be used for people who need at least a moderate level of mental health support.
The plan is not the referral
This is the step most people are surprised by. Medicare's own explanatory notes state plainly that a Mental Health Treatment Plan is not considered a referral. Your GP writes both: the plan establishes eligibility, and a separate written referral authorises a course of sessions with a psychologist.
A valid referral is signed and dated, and includes your name, date of birth and address, your symptoms or diagnosis, a list of current medications, the number of sessions you are referred for, and a statement that a plan has been prepared. Your psychologist must hold that referral before the first session, and must keep it for two years.
Who can write it
The referral has to come from a GP or prescribed medical practitioner at the practice where you are enrolled in MyMedicare, or from your usual medical practitioner — the practitioner or practice that has provided most of your care over the past twelve months, or will over the next twelve. A psychiatrist or paediatrician can also refer you directly.
Six sessions, then a review
An initial course of treatment is a maximum of six individual sessions. At the end of that course your psychologist writes to your GP with the assessments carried out, the treatment provided and a recommendation about what should happen next.
Your GP then reviews the plan and can refer you for further sessions, up to the annual cap. Reviews are claimed using ordinary time-tiered GP consultation items, and a review is not to be done more than once in three months, or within four weeks of the plan being prepared.
Ten sessions a calendar year
Medicare benefits cover up to 10 individual and 10 group mental health treatment services per calendar year, running 1 January to 31 December rather than from the date of your plan. Up to two of the ten individual services can be used for a family member or carer to take part in your treatment.
If sessions on a referral go unused at the end of the year, you do not need a new referral for them — but any you use from 1 January count towards the new year's ten.
Your plan does not expire
A Mental Health Treatment Plan does not expire, and a new one should not be written each year. If you return to therapy after a break, what you usually need is a new referral rather than a new plan. A fresh plan is intended only for exceptional circumstances, such as a significant change in your mental health.