Does health insurance cover mental health?

Published on
November 30, 2023
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When it comes to health, everything is connected. It’s hard to take care of your physical health if you’re constantly anxious or depressed. On the flip side, it’s hard to have a positive mindset if you’re dealing with chronic pain or stressful medical conditions. This is especially true if you’re worried about the cost of getting the care you need. The good news is that health insurance makes caring for both your physical and mental health much more affordable.

Many mental and behavioral health services have to be covered

Insurance companies have some say over what they cover and to what degree. Some services, however, are defined by the US Health Care Department as essential health benefits.

All insurance providers are required to cover essential health benefits. The specifics vary by state, but essential benefits always include emergency services, maternity and newborn care, lab services, preventative care, pediatrics, prescription medication, and mental health services.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act passed in 2008, requiring coverage for mental health that’s comparable to physical health coverage.

Currently, essential mental health services include:

  • Behavioral health services, like therapy and counseling
  • Inpatient services
  • Substance use treatment

Treatment for all mental health disorders, from anxiety and ADHD to bipolar depression, is covered. If you’re concerned about your dependence on substances, that’s covered too. Insurance companies are required to charge the same copay for office visits as those for medical or surgical office visits. They also can’t deny coverage for pre-existing conditions. If you were diagnosed with ADHD as a kid, you can still seek treatment as an adult and rest easy knowing you’ll be covered. Marketplace plans can’t add a cap on yearly or lifetime essential care costs, either. You’ll still have to meet your annual deductible first, but the rest of your care will be covered.

What are the limitations of mental health care coverage?

While insurance companies can’t enforce an annual cap on visits to a mental health professional, they’re still allowed to define what types of visits are considered “medically necessary.” For this reason, depending on the type of care you need, your insurance may only cover a certain number of mental health visits per month or year.

Similarly, while prescription medications are covered, you may still have to pay a certain percentage. HealthBird Rx card is a great, free resource to further reduce the cost of your next trip to the pharmacy. With insurance coverage and an Rx card in hand, most medications are affordable– much more affordable than the cost of paying out of pocket, or neglecting care until it’s a far more costly emergency.

How to use your insurance for mental health care services

Getting the care you need isn’t nearly as intimidating as it seems. Now, insurance providers often cover telehealth options so that members can talk to a psychologist or psychiatrist from the privacy of their own homes. To find out what services are covered by your current health insurance plan, review your plan’s policy guide or call your insurer’s customer service hotline for the details.

If you’re not insured or your old plan isn’t cutting it, you’re in luck. Open enrollment is the best time to enroll, so now is the perfect time to start weighing your options.

The HealthBird app is a great place to start. After you answer a few questions, you’ll have a list of quotes curated just for you. Look over the details of each plan in the running to see which one is the best fit for your care needs.

If you’re not sure which one is right for you, reach out to our 24/7 chat, and we’ll point you in the right direction. We’re feeling more relaxed just thinking about it!

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