Mental Health Services and Health Insurance Coverage

There was a time in the not so recent past when the majority of health insurance plans offered little if any coverage for mental health services.  However, with the passing of the federal 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) mental health services and health insurance coverage are now synonymous.

The MHPAEA stipulated that if coverage is provided for mental health, behavioral health, and substance use disorders it will be equal to coverage provided for physical health coverage.  In addition, while prior to the passage of MHPAEA insurers could limit the number of mental health visits in a given year, that arbitrary restriction is now illegal.

Further cementing this positive change for people in need of mental health services, the Affordable Care Act (ACA) of 2010 requires most private and small employer health insurance policies, and all the plans offered through the insurance exchanges, to provide coverage for services related to mental health and substance use disorders.  Most insurance plans now must even cover preventative services, such as behavioral assessments for children or depression screening, at no additional cost.

These new laws can change the landscape for those individuals who have been suffering from mental health conditions but had no insurance benefits to help defray the costs.  The high cost related to mental health services was one of the primary reasons that many people who needed treatment for mental health disorders went untreated.  Unfortunately, not everyone knows about these improvements for mental health services and health insurance coverage.

Finding Out if Your Insurance Plan Offers Mental Health Benefits

In most cases, the description of what your health plan covers is found in the enrollment materials provided.  There it is outlined exactly what the plan offers in terms of mental health services and the health insurance coverage for them.  If those materials are not available, visit the human resources department at your employer or call the insurance company directly to get these details.

Not all insurance companies offer mental health coverage, but if they do offer it the costs and benefits must align with the parameters of their physical health coverage costs and benefits.  This means that if the plan charges a $30 copay to see a specialist for a physical health condition, they can only charge a $30 copay for mental health providers.

Large employer health care plans may or may not provide for mental health services, but if they do they must comply with the recent laws.  However, all small business plans and individual plans are required to offer coverage for mental health services that meet both the MHPAEA and the ACA guidelines.

Do Medicaid and Medicare Offer Mental Health Services Coverage?

While the level of coverage for mental health services may not reach the level of individual or small company health care plans, all state Medicaid programs will provide some coverage for adults and extensive coverage for children under the Children’s Health Insurance Program.  Services provided for children include therapy, social work services, counseling, peer support, and treatment for substance use disorders.

Medicare offers mental health services and health insurance coverage through Medicare Part A, hospital coverage; Medicare Part B, medical insurance for sessions with a therapist or clinical psychologist including any lab tests ordered; and Medicare Part D, medications to treat a mental health condition.

Achieve TMS Largest Provider of dTMS Depression Treatment

Too many people are still unaware of the positive changes that have occurred regarding mental health services and health insurance, and don’t seek the treatment they need.  Many who suffer from the devastating effects of persistent depression have insurance benefits that would provide much needed treatment.

Achieve TMS East is a premier provider of the leading alternative treatment for major depressive disorder—deep transcranial magnetic stimulation (dTMS).  This noninvasive therapy has demonstrated in over 60 clinical studies its safety and effectiveness in treating medication-resistant depression.  There is no anesthesia required and no down time, making this a well tolerated depression treatment.

Call us today for more information about this exciting new treatment for depression, and for your free insurance review at (877) 297-5816.

Sources:
http://www.apa.org/helpcenter/parity-guide.aspx
https://www.mentalhealth.gov/get-help/health-insurance/
http://www.nami.org/About-NAMI/NAMI-News/Health-Insurance-and-Mental-Health-Services
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