Taking care of your mental health is absolutely critical to overall personal wellness. But sometimes, accessing mental health services can feel confusing and expensive, even if you have insurance.
Understanding what mental health services your insurance plan covers is the first step in getting the care you need and ultimately deserve.
A Brief History
To promote mental health, lawmakers passed a bill in 2008 called the Mental Health Parity Act, better known as MHPA.
This law does not require that health insurance plans include mental health services. However, it does state that if mental health services are offered by an insurance provider, that coverage must be comparable to the physical health coverage offered. This law also states that any health insurance plan that offers mental health services must cover behavior treatment like psychotherapy, counseling services, mental inpatient services, and substance use disorder treatment.
Unlike coverage for dental or vision needs, there currently aren’t health insurance options that single out mental healthcare. When available, mental health coverage is within the framework of a medical health insurance policy. If you’re shopping for new health insurance and want to only consider plans that also provide mental health coverage, visit https://www.healthcare.gov/ to compare plans and find one with the coverage you’re seeking.
What Will I Actually Pay For Mental Health Services If I Have Insurance?
With any mental health coverage, you will be responsible for any copays and deductibles. However, the parity law mentioned above states that you cannot be held to two different deductibles for mental health and physical health services. What does this mean exactly? Well, if you have a $3,000 deductible and pay $1,500 for physical healthcare and $1,500 for mental healthcare, it means you have met your deductible for the year.
One important reminder when it comes to financing your mental healthcare—mental health providers can choose whether to accept insurance or not and what plans they want to work with. To minimize costs, try seeking treatment with a provider in your plans’ network.
About now, you might be wondering to yourself, what types of mental health services do insurance providers typically offer?
Medicaid
If you’re unfamiliar with Medicaid, it Is a public state and federal combined health insurance program that offers health insurance coverage to low-income individuals who meet certain criteria. Medicaid plans are known for having low costs, but sometimes the choice of mental health professionals may be more limited than in private health insurance plans.
Medicaid does generally cover inpatient hospitalization, psychiatric rehabilitation, prescription drugs, and crisis intervention. By law, however, Medicaid does not cover state hospital or specialty psychiatric hospital care for people aged 22-64.
Medicare
Medicare is a federal health insurance program that provides coverage similar to private health insurance. Medicare does not cover a broad range of community-based services for people with mental illness. Medicare does cover inpatient hospitalization, partial hospitalization, outpatient services with licensed mental health professionals, emergency care, and prescription drugs under Medicare Part D.
Private Insurance
Private health insurance plans vary in their health and mental health benefits but typically offer fewer mental health services than public mental health programs. Private plans that are available through an individuals’ job will typically cover inpatient hospitalization, partial hospitalization, outpatient mental health treatment, emergency care, and prescription drugs. If you’re not sure about your benefit amounts and limits which vary by state and the plan you are on, ask your human resources representative for more clarification.
A Quick Caveat
Remember, just because an insurance plan offers coverage for mental health doesn’t mean that all services are automatically covered. For example, stress caused by life changes like a move or financial difficulty may not be covered by your insurance plan. However, that same insurance plan may cover stress therapy if that stress is related to something like an anxiety disorder. If you are looking for an insurance plan that covers mental health services, make sure you do your research in order to find an insurance plan that adequately covers all your needs.
Protect Your Long-Term Mental Health
If your mental wellbeing and general health are at the top of your priority list, you might have pressing questions about your health insurance. If you are from the Kosciusko area and have questions about your health insurance options, set up a time to meet with insurance agent, Michael Suhany. With his years of experience, he can walk you through various insurance plans and find one that prioritizes your long-term mental health needs. Contact him today and set up an appointment.