Mental and physical health are equally essential to your general well-being.
However, professional psychiatric services can be costly for both short-term crises and chronic conditions. As a result, many people struggling with such issues see the doctor less, or not at all, to save money.
Getting insurance that covers mental condition treatment can help, but only if you use it wisely. Let’s review some of the best coverage options and share some tips on how you can make the most out of it.
Insurance & Mental Health
Whether you’re already on a plan that incorporates mental health services depends on your provider. If the company does cover such assistance, it must include the following conditions in its services:
- Substance abuse disorders
- In-patient services and hospital stays
- Behavioral health treatment (such as talk therapy and counseling)
While these items seem all-inclusive, not all insurers read them that way.
For example, if you need treatment for stress as part of a generalized anxiety disorder, you might get it, but not if it’s due to significant life changes. Moreover, the amount you have to copay for talk therapy depends on your insurance plan.
If you’re looking for a policy that’ll cover necessary mental health aid, there are two ways to go about it. If you use the state-provided option, you should understand the laws behind it.
Mental Health Parity Act & Medicare
The state adopted this act in 1996. It says that healthcare plans don’t need to provide mental health benefits. If they do, though, they MUST be at least equal to medical and surgical coverage.
For example, your insurers can’t require $50 in copays for visiting psychologists if they demand $35 for seeing your primary care provider. Moreover, the same non-financial treatment limits must apply.
Insurance companies can still try to reduce their costs. For example, they might evaluate your case after a set number of therapy appointments. Your coverage could exclude specific diagnoses, as long as it clearly states it.
So, always read the fine print, or you might get stuck with a subpar plan.Medicare
The Parity Act doesn’t apply to Medicare but covers many mental health services. In a nutshell:
- Medicare Part A. The hospital insurance also pays for the necessary in-patient treatment you’d get in a psychiatric facility.
- Medicare Part B. If your doctor orders services outside the hospital, such as seeing a psychiatrist or a clinical psychologist, this part of the plan manages the expenses.
- Medicare Part D. The prescription drug insurance also helps with medication costs for treating psychological conditions.
Therefore, if your current insurance company limits the scope of the services you can receive, Medicare is a possible option. It’s not the only one, though.
If the coverage by Medicare isn’t enough, you could sign up for a program. Alternatively, check out the health insurance options provided by various private companies with the knowledge you have of the Parity Act.
Employee assistance programs are the most notable example if you go for the first option. Your employer pays EAP benefits, and accessing them is free for you.
Note that, while EAPs aren’t long-term solutions, they’ll take you to a professional who’d evaluate your needs, initiate short-term treatment, and get you the needed referrals.
Once you exhaust your EAP benefits, learn whether your employer has access to discounted out-of-pocket rates. If yes, you could continue to receive care from your current doctor, which is a smarter recovery strategy than changing therapists mid-treatment.
Plus, EAPs renew each year, giving you a new portion of free benefits.
If you’re employed, you could also check the variety of insurance plans that your company offers. If you need prolonged care, a more expensive policy could save you money in the long run.
The Bottom Line
Overall, it’s 100% possible to get a plan that doesn’t cost you a fortune and covers all your needs. All you need is a bit of research and persistence.
Once you’re holding a policy that provides you with the necessary services, use it. That’s the best way to get better in the long-run, and you’ll thank yourself in the future.