Will health insurance pay for mental health?

Does health insurance cover mental health? Not only will you find that mental health services are likely provided by your insurer, they can’t cost any more than other medical services by law. No matter where you get health insurance, it likely comes with mental health coverage.

Now that you know health insurance does cover mental health, enter your ZIP code into our free quote tool to see what you could pay for a health insurance plan today.

Are mental health services covered by health insurance?

There was a time when it was harder to get mental health services, as the range of conditions weren’t often treated like the serious medical issues that they are. Insurance services could choose whether or not to offer mental health coverage.

Now, however, according to the Centers for Medicare and Medicaid Services, insurers aren’t allowed to offer lower coverage for mental health services. They have to treat mental health care the same as medical and surgical coverage.

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Does insurance cover therapy?

Is therapy covered by insurance? Whether or not you have coverage for your therapy services will likely depend on your health insurance plan. Your mental health care is very important, but insurance plans don’t offer the same services or prices across the board.

When does health insurance cover therapy? If you’ve got mental health insurance from your health insurance company, then you can get affordable coverage. But if you choose a provider that is out of network, you may have to pay out of pocket for what could’ve been a therapist covered by insurance.

Does my insurance cover therapy?

Does medical insurance cover therapy? It will likely depend on your insurance plan, and which provider you have to go to may be limited as well. If you need insurance that covers mental health services, you should verify that your insurer provides that coverage ahead of time.

If you’re wondering if your insurance company accepts a certain mental health provider, there are a few options available. If you need to find a mental health provider through your insurer, you can do the following:

• Check your insurer’s website
• Call the phone number on your insurance card
• Ask your primary care doctor to recommend someone in-network
• Call the mental health provider directly and ask if they take your insurance

It’s always best to find a provider that is in your health insurance plan’s network so you don’t have to pay out of pocket.

Are there mental health Medicaid services?

Under Medicaid, most low-income individuals can get access to mental health services as well as substance abuse treatment. Given that low-income communities are often underserved, the government has enacted the Medicaid program to ensure treatment is available.

Furthermore, Medicare will also cover a number of mental health services, including free depression and substance abuse services.

What is the Mental Health Parity law?

In 2008, the Mental Health Parity and Addiction Equity Act was passed to give people affordable access to mental health services they need. Under this act, insurance companies:

• Must provide coverage for mental health services at the same cost as medical/surgical services
• Must cover substance abuse and mental health services
• Cannot charge higher co-pays or establish limitations specific to mental health services

Your insurer has to provide coverage for mental health that is equal to your ordinary medical coverage. The insurer has to offer mental health, behavioral health, and substance abuse services. Furthermore, there can’t be any higher costs when you see a mental health professional.

If you find out that your insurer hasn’t been meeting these standards, you can always report this to your local insurance commissioner.

What should you know about your rights under the law?

Under the Parity Act, you have a right to equal coverage for your mental health services. If you feel that an insurer is violating your rights, then you have every right to report it to your state’s insurance commissioner.

You can do this in a few ways, including:

• Filing a claim on your insurance commissioner’s website
• Calling or emailing the listed address
• Visiting in person to file the claim

Once you’ve filed the claim, you can begin looking for an insurer that does provide access to mental health services.

How can I find mental health insurance coverage?

Since many insurers offer mental health services, it’s all about finding an insurer that offers the other things you need in life as well. For instance, because you know that the mental health services are covered, you may want to consider a plan that also provides help paying for vision services.

Some of the most popular health insurance companies for mental health include:

• United Healthcare
• Cigna
• Aetna
• Kaiser

Not only do the above insurers have a 24/7 hotline or other online tools, they also have tools to get you qualified in-person help.

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Case Studies: Will health insurance pay for mental health?

Case Study 1: Comprehensive Coverage for Mental Health

In this case, Sarah sought treatment for anxiety and depression, she had health insurance with comprehensive coverage. Sarah’s insurance policy included mental health services as an essential component, ensuring that she could access therapy sessions, psychiatric consultations, and necessary medications.

Her health insurance covered a significant portion of the costs, requiring only a reasonable co-payment for each visit. This comprehensive coverage enabled Sarah to receive the mental health care she needed without experiencing a significant financial burden.

Case Study 2: Limited Coverage for Mental Health

John, dealing with ongoing stress and emotional struggles, discovered that his health insurance offered limited coverage for mental health services. While his policy provided some coverage for therapy visits, it imposed strict limitations on the number of sessions covered per year.

Additionally, certain specialized treatments and alternative therapies were not covered at all. As a result, John had to pay out-of-pocket for additional therapy sessions and explore alternative treatment options not covered by his insurance.

Case Study 3: Pre-authorization Requirement and Coverage

Mike experienced a mental health crisis and required immediate inpatient treatment at a psychiatric facility. When his family contacted their health insurance provider, they learned that prior authorization was necessary for inpatient mental health treatment. Fortunately, Mike’s insurance policy included coverage for such emergencies, and the insurance company promptly authorized his admission.

While there were still co-pays and deductibles to be met, Mike’s health insurance provided significant coverage for his inpatient mental health care.

Case Study 4: Out-of-Network Mental Health Providers

Emily wanted to see a specific therapist who specialized in the treatment of eating disorders, but she discovered that the therapist was out of network with her health insurance plan. While her insurance policy covered mental health services, it had a limited network of providers.

Emily had to decide whether to see the out-of-network therapist and pay the full cost out-of-pocket or seek an in-network therapist, potentially compromising her preference for specialized care. Ultimately, Emily chose to pay out-of-pocket to see the therapist of her choice, as the expertise and quality of care were her primary concerns.

Mental Health Services and Health Insurance: The Bottom Line

The good news is that all health insurance plans have to provide some form of mental health coverage. In addition, the cost of mental health services cannot be greater than the cost for other medical services. If your insurer doesn’t meet these standards, you can easily switch to another.

Now that you know health insurance does cover mental health, enter your ZIP code into our free quote tool to get an idea of what you can pay.

1. https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet

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