Mental Health Insurance Coverage

Posted: July 24, 2024

Health goes beyond your physical body. Your mental well-being plays a critical role in your overall health. Insurance companies haven’t always seen it that way, historically providing better coverage for physical conditions than mental health disorders. That is no longer the case.

A 2008 federal law known as the Mental Health Parity Law requires insurers to cover mental, behavioral and substance use disorder services. Let’s explore how this law and other factors influence your mental health insurance coverage.

What Is the Federal Parity Law?

Commonly referred to as the federal parity law, the Mental Health Parity Law regulates insurance companies to ensure mental health and substance use benefits are not more restrictive than medical and surgical coverage.

Parity protections apply to:

• Financial requirements: Copayments, deductibles, coinsurance and out-of-pocket limits must be treated equally.
• Treatment limits: The parity law essentially eliminates annual limits. However, increased visits must be deemed medically necessary.
• Care management: Patients are not required to get authorization for treatment before pursuing care.

How Do I Know if My Insurance Covers Therapy?

Does your insurance cover therapy services, counseling, anxiety treatment and other mental health treatments? The Mental Health Parity Law does not mandate that insurers include mental health services in their coverage. It simply enforces equality between mental health and physical health benefits.

Thankfully, most major group plans provide mental health care coverage. Plus, all Health Insurance Marketplace plans are required to cover mental health and substance use services, including:

• Psychiatric evaluations.
• Individual and group therapy.
• Family counseling.
• Substance use counseling.

Are All Mental Health Diagnoses Protected by the Parity Law?

The parity law ensures coverage for all mental health and substance use disorder diagnoses. Individual health plans can exclude specific diagnoses, but these exceptions must be made clear in your plan’s description of benefits.

Do All Mental Health Providers Accept All Insurance Plans?

Mental health professionals can choose whether or not to accept different insurance plans. You can check with your provider before receiving care to see if they take your insurance type.

Tips for Using Your Mental Health Coverage

Here are a few things you can do to get the most out of your insurance plan’s mental health coverage:

• Check your coverage: Check with your insurance company or human resources department for specific details about your coverage.
• Check your network: Ensure your mental health provider is in-network.
• Know your copayment and deductible: Find out your copay for mental health visits so you know what to expect. Also, be sure you understand how much you must pay out-of-pocket before your health insurance will begin making payments.
• Talk to your mental health provider: Before your appointment, ask if your provider accepts your insurance and what payment policies they have in place.

Alternative Ways to Get Mental Health Treatment

Private health insurance is not the only way to access mental health treatment. If you’re struggling to afford your health insurance premiums or your insurer doesn’t include mental health services, it may be time to explore alternative ways to cover your mental health care needs. These may include:

• A health savings account.
• Different types of supplemental insurance plans.
• Therapy apps.
• Employee Assistance Programs.
• Veterans Affairs.
• School counselors for college and university students.
• Nonprofit organizations.

Find the Best Mental Health Insurance Plan With Health for CA

Certified by Covered California, Health for California is here to help you find your best health insurance options. Our experienced agents will answer your questions and find an insurance plan that meets your mental health needs. Get a fast, free and easy quote today or contact us online to learn more. We’re happy to assist you in finding coverage in California.