Health Insurance and Mental Health Treatment

Receiving mental health treatment can be complicated if you do not have mental health coverage through your current insurance provider.

While many companies are required to provide some level of mental health coverage under most health insurance plans, not every company has developed this feature. Some companies only provide this level of health care to employees in higher ranked positions within the company, or you are required to work a certain number of hours each week to qualify. You will first need to determine the full extent of coverage available to you for mental health treatment before seeking alternative options to cover the cost of the mental health care you need.

Different insurance types will offer various health care plans, meaning even if your insurance covers some mental health needs, it may not be extensive enough for your situation. If you have determined you do not receive mental health treatment coverage through your health insurance provider, or your health insurance provider does not offer adequate coverage, you can seek alternative methods to obtain these services on a consistent basis.

How to Determine Your Level of Coverage

If your health insurance does not offer mental health coverage, you can look through the behavioral health portion of your plan to determine if any treatments are covered in this area. Certain mental health treatments will be listed under the behavioral health portion of your existing insurance plan and through this portal you can establish what treatments you may be eligible to receive.

Each health insurance plan comes with enrollment materials, and you will be able to find the information you need within these materials. Your insurance company is required by law to provide an easy-to-understand overview of your existing health care plan so that you can gain access to the answers you need in a timely fashion. You may need to call your health insurance provider directly to determine your level of mental health treatment coverage if it is not expressly stated in your enrollment literature.

If your current health insurance plan does not include mental health coverage, you can change your insurance package during times of open enrollment throughout the year. You will likely need to pay more per month for a health insurance package that includes mental health benefits. The difference may seem substantial at first but will ultimately cost less over time, as you will no longer have to worry about paying for mental health treatments out of pocket with an insurance adjustment. Paying for treatments on your own can prove costly if you need to receive ongoing treatment for a mental health issue.

How to Purchase Mental Health Insurance

For those of you who wish to purchase mental health insurance, there are numerous ways to achieve this goal. Your first option is to select a health insurance plan through the Health Insurance Marketplace, as doing so may save you money on the treatments you need. Through the Marketplace you will be able to compare different plans to decide what option offers you the mental health benefits you must have consistent coverage for. Eligible individuals may qualify for a discount on cost as well and you can research your eligibility in advance to see if you can save money by switching insurance plans.

Another option you can utilize to purchase mental health insurance is to switch your existing plan to a High-Deductible Health Plan, either through your current insurance company or with a different entity. Many High-Deductible Health Plans offer mental health insurance and treatment coverage for individuals who choose to pay for this option. If you are unsure of whether you can afford the increase in deductible, you can seek assistance through a health savings account to cover the difference in health insurance plans. By creating a health savings account, you will be able to pay the deductible on your mental health insurance plan with pre-tax money amassing throughout the year.

Alternatives to Mental Health Insurance

If you receive health insurance through an employer but are not entitled to mental health treatment coverage with this plan, you can seek alternative ways of getting the care you need. Speak with your employer about whether a Flexible Spending Account (FSA) is offered as part of your benefits package for the company. A Flexible Spending Account functions similarly to a health savings account as it provides you a way to collect pre-tax money throughout the year to be used for medical treatment in the future. Your FSA can help cover the cost of eligible mental health treatments, including visits to your psychiatrist and prescription medications. Using an FSA will also save you money as you will not be paying income tax on the mental health treatments you receive if you choose to pay for these services through the money in your FSA.

You can also speak with your employer about the Employee Assistance Program (EAP) offered through the company you work for. Typically, mental health benefits and mental health treatment are covered by the Employee Assistance Program. An EAP is paid for by your employer, and you can access the benefits of this program for free when you need to do so. You do not need to receive help for a work-related ailment to gain the benefits of an EAP. Through Employee Assistance Program benefits, you can:

  • Receive evaluations from a mental health professional.
  • Begin crisis intervention when/if necessary.
  • Have short-term treatment for mental health issues.
  • Gain referrals for long-term treatment options and plans.

Free benefits through an Employee Assistance Program renew each year so you can continue to receive short-term treatment over time through this initiative. However, if you need long-term mental health treatment, you can speak with your employer about discounts you may be eligible to receive. Oftentimes employers will supply out-of-pocket discounts to employees who are continuing treatment with a mental health provider obtained through EAP benefits. By choosing to pursue this option, you are avoiding the process of selecting a mental health counselor again and will avoid paying the cost of another mental health evaluation.

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