Australia: Health Insurer Would Provide First Psychedelics Therapy Coverage For Mental Health

The Perth-based Health Insurance Fund of Australia (HIF) could soon become the first health provider of the country to offer MDMA and psilocybin insurance, aligned with successful clinical studies involving PTSD, substance abuse and anxiety treatments, as first reported by Kellie Balaam on PerthNow.

The company’s CEO, Justin James, said the medicinal potential of psychedelics is “extraordinary” and that he wishes the Health Insurance Fund to be at the forefront of helping its insured population access psychedelics, should they get government approval. 

“I have a keen interest in what is coming and what we, in being a health fund, can provide members into the future, particularly around better choice and access,” James stated. 

He further added that, post-COVID, one in five claims involve mental health episodes, “and that’s appearing in much younger areas of society than it ever has before.” This evidence translates to more people suffering more “if we don’t have alternatives, if we don’t start seeing some progressive ways to deal with these issues.”

In terms of how the insurance could potentially work, James explained that the HIF would be willing to partner with providers and manufacturers “to reduce the cost that we might not be able to cover in a full rebate as well.” 

As a reminder, consumer affordability is usually the greatest challenge when it comes to health insurers. In James’ own words, “this affordability is across two lenses. First, the price of private health insurance and the annual premium increase required to pay for claims inflation. And second, the out-of-pockets incurred when using our services.”

If clinical trials continue proving success for psychedelic-assisted therapies, we’ll have to stay tuned to learn how—and where—these insurances will unwind.

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