Mental Health Insurance Coverage
Mental illness comes in many forms, including depression, bipolar disorder, anxiety, and more. When someone develops a mental illness, they need to find the right treatment in order to learn to manage their symptoms. However, one thing often delays a person from reaching out to get help. They ask themselves, “Does insurance cover mental health?” If they assume it does not, they may spend months or years not getting the help that is available to them. Insurance does cover several types of mental health coverage, making it important for each person to understand their options.
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Does Insurance Cover Mental Health?
The short answer to the question “Does insurance cover mental health?” is yes, it does. Mental health is considered a vital part of a person’s overall health and coverage for it is considered a basic health service. For this reason, most insurance companies offer plans that cover some type of treatment for mental health disorders.
According to mentalhealth.gov, help is available in relation to mental health coverage for people who have been denied coverage. This includes those who reached a limit on their plan, including copayments, deductibles, and yearly visits, or who have overly large copay amounts or deductibles. The Mental Health and Substance Use Disorder Coverage Parity laws come into play here because they require most health plans to treat mental health benefits similarly to how they treat benefits for medical and surgical needs.
Types of Insurance We Accept
Questions To Ask Your Insurance Company
Someone with insurance who wants more information about getting care for their mental health can contact their company. They should prepare a list of questions ahead of time so they can obtain all the information they need. An insurance company representative should be able to answer questions for their customers, including the following:
- What type of plan do I have?
- What is my deductible and have I met it?
- What is my co-payment for mental health treatments?
- What types of mental health treatment programs can I use?
- Do I need prior approval before beginning any particular program?
- Is there a limit to how long I can attend a residential or outpatient program?
- Is there a limit to how many therapy sessions or related appointments I can have?
- Are prescription medications covered by my plan?
- Will I need to fill out a form after treatment in order to receive compensation?
- Who in my family is also covered for mental health treatment?
- Which mental health programs are in my network?
- What is the policy on using treatment outside of my network?
If a person does not have access to an insurance company policy book, ask the rep to provide a link for it or to snail mail a copy for their records.
The Affordable Care Act
The Affordable Care Act (ACA), also known as Obamacare, was signed into law in 2010 by President Obama. Its goals included making healthcare more affordable to those who need it. Under this act, all marketplace plans must provide coverage for mental health services. This includes behavioral health treatment, such as psychotherapy and counseling, mental and behavioral inpatient services, and treatment for substance use disorders. The latter part proves important because about half of those who have at least one diagnosable mental illness also struggle with an addiction to drugs or alcohol.
Which services are covered depends on the specific health plan the person uses and the state they live in. The insurance company will be able to answer specific questions about their coverage.
One main advantage of ACA is that its marketplace plans cannot deny a person coverage because they have a pre-existing condition. This includes mental illnesses and substance use disorders. Coverage for these conditions begins the day the individual’s ACA coverage starts. In addition, marketplace plans cannot put yearly or lifetime dollar limits on someone’s benefits, including mental health and addiction treatment.
Last, the ACA specifies that insurance companies in their plans cannot place more restrictive limits on things than they do for medical or surgical services. These include financial limits, such as copayments and deductibles, number of visits or days of treatment covered, or requirements for pre-approval of treatment.
Does Insurance Cover Mental Health: Medicaid and Medicare
Insurance coverage for mental health is not limited to the usual private insurance company options many people have through their jobs. Medicaid includes some mental health care services as part of its program. Services include counseling, medication management, peer support, social work services, and substance use disorder treatment. Congress passed the Mental Health Parity and Addiction Equity Act which improves the ability of people covered by Medicaid to get mental health and addiction treatment. Coverage can extend to some beneficiaries, including children in need of mental health services.
Medicare also provides mental healthcare for those covered by it. Medicare Part A (Hospital Insurance) covers mental health care services provided to a person admitted to a hospital. Part B (Medical Insurance) covers mental health care services not provided while a hospital patient, such as individual and group therapy, family therapy, psychiatric evaluations, depression screenings, medication management, and diagnostic tests. Medicare Part D covers prescription drugs required to treat mental health disorders.
What Kind of Mental Health Treatment Does Insurance Cover?
After answering the question “Does Insurance Cover Mental Health”, the next question usually involves wondering what types of mental health treatment insurance covers. Common types include:
- Residential: A person lives in a facility and receives round-the-clock care
- Outpatient Programs (including Intensive Outpatient Programs and Partial Hospitalization Programs)
- Individual, group, and family therapy
- Medications and medication management
- Screenings for mental health conditions
Additionally, many insurance plans cover other therapies that help people manage and overcome their mental health disorder symptoms. These can include holistic therapy, EMDR therapy, neurofeedback therapy, and more.
What Kind of Mental Health Treatment Does Insurance Cover?
After answering the question “Does Insurance Cover Mental Health”, the next question usually involves wondering what types of mental health treatment insurance covers. Common types include:
- Residential: A person lives in a facility and receives round-the-clock care
- Outpatient Programs (including Intensive Outpatient Programs and Partial Hospitalization Programs)
- Individual, group, and family therapy
- Medications and medication management
- Screenings for mental health conditions
Additionally, many insurance plans cover other therapies that help people manage and overcome their mental health disorder symptoms. These can include holistic therapy, EMDR therapy, neurofeedback therapy, and more.
Mental Health Treatment in Nashville, TN
Anyone who has a mental illness knows how difficult it can make their lives. They want to find help but may not know what their options are when it comes to finding quality treatment. Arbor Wellness in Nashville provides a full spectrum of care for mental health disorders, including residential and outpatient programs. We understand that each person has individual needs and design a treatment plan with those needs in mind.
If you want to take charge of your mental health and improve your life, visit our admissions page now. Get in touch and we can answer any questions you have.
If You are in need of immediate assistance...
Don’t hesitate to contact us immediately. In the case of a medical emergency please contact 911 or visit your local emergency department.
We Work With Most Major Insurance
Did you know most major health insurance plans with out-of-network benefits can help cover most of the costs associated with our program? Click below to find out your coverage and treatment options right now.