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Does health insurance cover mental health?

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Health insurance companies must cover mental and behavioral health coverage at the same level as they cover medical coverage. 

The Mental Health Parity and Addiction Equity Act in 2008 demanded that insurers treat mental health and substance use disorders the same as physical coverage. The mental health parity law includes employer-sponsored health insurance for companies with 50 or more employees; Affordable Care Act (ACA) plans; Medicare; and the Children’s Health Insurance Program. 

The plans can’t charge higher copays than physical health care or restrict behavioral health coverage. Insurers also can’t cap mental health services, such as annual limits. Previously, a health insurer might have had separate coverage caps and deductibles for mental health services and physical care. That changed with the 2008 mental health parity law. 

The law also disallows insurers from putting annual limits on mental health visits. Insurers can’t place absolute coverage restrictions, but they can review your situation after a certain number of mental health appointments and decide whether to approve future visits. 

 

Does health insurance cover therapy? 

Health insurance covers mental health visits, just like it handles primary care provider visits. 

The ACA requires that insurers accept you regardless of pre-existing conditions. Previously, a health plan in the individual market could deny you or charge much higher rates if you had pre-existing conditions. The ACA changed that. 

In addition to mental health and substance abuse care, health insurance covers:

  • Outpatient care, including mental health treatment
  • Inpatient care
  • Prescription drugs
  • Emergency care
  • Labs

Similar to physical health care, you’ll want to stay within the plan’s provider network when possible. Staying in the plan’s provider network will keep down costs. 

Depending on the plan, health insurance either charges more for out-of-network providers or doesn’t cover them at all. For instance, preferred provider organization (PPO) plans usually allow for out-of-network care, but charge more for that care. Health maintenance organization (HMO) plans typically don’t cover any out-of-network care. In that case, you would have to pay for all of that health care service. 

 

How much does mental health treatment cost? 

Mental health costs vary by health plan. Some may offer no or low-cost copays when you visit a provider, while another may charge more. 

The mental health law doesn’t require a certain copay. Instead, the law demands a health plan charge the same for mental health and comparable physical health visits. 

 

What’s the best health insurance for mental health? 

Health insurance companies must cover mental health. So, any health insurance should cover that care. 

You’ll want to dig into the plan costs and provider network. How much you pay will vary by plan. Health plans that have lower premiums often have higher deductibles. A deductible is what you pay for health care services before your health insurer begins picking up a portion of the costs. 

You pay more for health care services in a high-deductible health plan, but less for premiums. 

You’ll want to review the cost of copays for mental health visits when choosing a plan. Copays are often between $20 and $50. 

However, that’s not as important as the cost of premiums and deductibles. Premiums and deductibles cost more than a copay, so you’ll want to run those numbers. 

 

Do short-term health plans cover mental health care? 

Short-term health plans don’t usually cover mental health care and substance abuse care. 

Most states allow short-term health plans, which let people sign up for a year with the chance to extend the plan for three years. These low-cost plans don’t offer the same protections found in other plans. 

Short-term plans aren’t technically considered health insurance. Instead, short-term plans have limited coverage and often don’t offer prescription drug benefits, pregnancy and child care. 

Short-term health plans have low premiums but much higher out-of-pocket costs than regular health insurance. These plans also have coverage caps, so you wind up paying all of the health care costs once you reach the limit. 

Insurers that offer short-term plans have more leeway than a standard health insurance plan. So, you’ll want to dig into the fine print and ask questions about mental health and substance abuse coverage. 

 

How to compare health insurance plans

The mental health parity law and the ACA mean you don’t have to worry about having a standard health insurance plan not covering mental health care. 

However, health plans can vary. If you’re concerned about mental health coverage, here’s what you want to review when comparing health plans:

  • Check out a plan’s provider network to see the mental health options in your area. If you’re receiving mental health care, make sure your providers are in the plan’s network or you’ll have to pay more or all of the care costs. 
  • See if the health plan covers your prescriptions and how much you’ll have to pay.
  • Look into health plan costs, such as copays, deductibles, coinsurance and out-of-pocket costs. These costs will help you compare health plans. 

The good news is that you no longer have to worry about your health insurance denying or limiting mental health coverage. However, make sure to dig into the information when comparing health plans to find the plan that works best for you.