Does insurance cover mental health?
If your insurance plan falls under the Mental Health Parity and Addiction Act (and most health plans do), your insurance company is required to cover mental health treatment. In addition to the federal requirements, many states have additional rules that apply to mental health care, expanding the reach of the federal law.
Additionally, your plan can’t charge higher copays than for physical health care or restrict behavioral health coverage. Insurers are also restricted from capping mental health services.
As with any treatment plan, however, your insurer can review the medical necessity of the treatment and decide whether to approve future visits.
Does health insurance cover therapy?
Health insurance covers mental health visits just like it handles all office visits.
Previously, a health plan in the individual market could deny you or charge much higher rates if you had pre-existing conditions, including mental health conditions. The ACA changed that.
Health insurance covers the following mental health and substance abuse treatment:
- Outpatient mental health care
- Inpatient treatment for mental health
- Prescription drugs
- Emergency care
- Labs
Depending on the plan, you will pay more to see an out-of-network provider or have no out-of-network coverage at all. For instance, preferred provider organization (PPO) plans usually allow for out-of-network care, but charge higher deductibles and copays. Health maintenance organization (HMO) plans typically don’t cover any out-of-network care.
How much does inpatient mental health treatment cost with insurance?
Mental health costs vary by health plan. If you are receiving inpatient care, you can expect to pay the same out-of-pocket costs (coinsurance amounts and deductibles) that you would be charged for any other inpatient treatment.
Of course, the type of treatment you receive and how long you require treatment will determine the overall cost of your care.
Silver plans provide a good balance of monthly premiums with out-of-pocket costs. Coinsurance is 70% with a silver plan, meaning you will pay 30% of the costs after your deductible is met, up to the out-of-pocket limit. Silver plans are a good choice for people who are in generally good health but don't want high out-of-pocket costs if something goes wrong. Bronze plans are a popular choice with those who value low monthly premiums and are willing to pay more when they need care. Coinsurance is set at 60%, meaning you will pay 40% if you do need care, up to the out-of-pocket limit. Bronze plans are good for those who don't expect to need many services outside of preventative care throughout the year.
ACA platinum plans have the highest monthly premiums, but the lowest out-of-pocket costs. You'll pay more monthly in return for lower deductibles, copays and coinsurance amounts. Coinsurance with platinum plans is 90%, which means you pay 10% after the deductible, up to your out-of-pocket limit. Platinum plans are good for those who anticipate a lot of medical needs throughout the year.
Gold plans cost a little less than platinum plans, and come with higher out-of-pocket costs. The coinsurance amount on a gold plan is 80%, which means you pay 20% after the deductible, up to your out-of-pocket limit. A gold plan is a good idea if you think you'll need a lot of care throughout the year, but don't want to pay platinum premiums.Health insurance finder tool
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Employer-sponsored health insurance
Preferred-provider Organization (PPOs)
Preferred-provider organization (PPOs) plans are the most common type of
employer-based health plan. PPOs have higher premiums than HMOs and HDHPs, but
those added costs offer you flexibility. A PPO allows you to get care anywhere
and without primary care provider referrals. You may have to pay more to get
out-of-network care, but a PPO will pick up a portion of the costs.
Find out more about the differences between plansHealth maintenance organization (HMO)
Health maintenance organization (HMO) plans have lower premiums than PPOs.
However, HMOs have more restrictions. HMOs don't allow you to get care outside
of your provider network. If you get out-of-network care, you'll likely have to
pay for all of it. HMOs also require you to get primary care provider referrals
to see specialists.
Find out more about the differences between plansHigh-deductible health plans (HDHPs)
High-deductible health plans (HDHPs) have become more common as employers look
to reduce their health costs. HDHPs have lower premiums than PPOs and HMOs, but
much higher deductibles. A deductible is what you have to pay for health care
services before your health plan chips in money. Once you reach your deductible,
the health plan pays a portion and you pay your share, which is called
coinsurance.
Find out more about the differences between plansExclusive provider organization (EPO)
Exclusive provider organization (EPO) plans offer the flexibility of a PPO with
the restricted network found in an HMO. EPOs don't require that members get a
referral to see a specialist. In that way, it's similar to a PPO. However, an
EPO requires in-network care, which is like an HMO.
Find out more about the differences between plans
Learn more about individual insurance plans
Know more individual insurance / ACA 
Know more individual insurance / ACA 
Best health insurance for mental health coverage
Health insurance companies must cover mental health, so any health insurance should cover you, but plan costs and access to providers will vary. When choosing a plan, it’s best to consider the balance of monthly premiums and out-of-pocket costs.
If you anticipate needing regular mental health treatment, it might be worthwhile to choose a plan with a higher monthly premium but lower out-of-pocket costs. It’s also vital to look at the network and make sure the doctors and clinics you need are covered.
The best insurance for mental health really depends on your specific needs, so compare your options and consider your budget before you buy
Do short-term health plans cover mental health care?
Short-term health plans don’t usually cover mental health 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 and are only meant to be a temporary solution.
