How to Make Sure Your Insurance Will Cover Mental Health Services
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Your health insurance will provide mental health coverage, but you may want to supplement it with disability or long-term care policies.
According to reports from the National Alliance on Mental Illness (NAMI), approximately 1 in 5 adults in the United States experience the effects of mental illness each year. That's a total of 43.8 million people.
With so many people dealing with mental health issues, it should be treated as an important aspect of health insurance. Yet many people are in the dark about whether their insurance will provide them with mental health coverage, or how to get it if it doesn't.
The Mental Health Parity Law
Our mental health is just as important to our overall well-being as our physical health. Unfortunately, insurance companies have not always seen it that way.
But in 2008, things changed with the passing of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equality Act (that mouthful is normally referred to as the Mental Health Parity Law). This law has been in effect for almost a decade, but many people are still unaware that it exists and how it can help them get the coverage they need.
How the Parity Law Helps Policyholders
The Mental Health Parity Law requires all insurance companies to treat mental, behavioral, and substance abuse disorders equal to any physical medical coverage they provide. Health insurance companies, in other words, must treat both types of coverage equally. That means that an insurer cannot charge a ridiculous co-pay for office visits at a mental health facility and then charge much less for a visit to a medical doctor's clinic (for a primer on health insurance payments, see All the Ways You Pay: Premiums, Deductibles, Co-pays, and Coinsurance).
This law also offers protection against annual limits for mental health treatment. There was once a limit on the number of mental health care visits that a patient could have in a year. This law has done away with that limit, ensuring that patients can get the assistance they need.
The law, however, does not stop insurance companies from placing limits on what they will pay in relation to what they define as medically necessary. Therefore, it is important for all policyholders to find out what their insurance policy will cover and whether there are any limits to their coverage.
Other Types of Mental Health Coverage
There are other types of health insurance coverage that may offer benefits to those who require mental health care.
Disability insurance is a plan that offers benefit payments when the insured becomes unable to work. It is designed to supplement as much as 65% of the person’s gross income they received while they were able to work, on a tax-free basis.
Each disability insurance policy is different. Find out as much as you can about a policy before taking it out. In some cases, you may require a second disability policy specially designed for mental health coverage (for related reading, see 12 Disability Benefit Riders to Improve Your Coverage).
Many people do not consider this type of insurance a necessity. Everyone from business professionals to laborers expect to remain in good health throughout their working years. Illness and accidents, however, are unexpected, so it's important to take precautions (find out Why You need Disability Insurance).
You may have disability insurance through your employer. That's a great perk, but it's important to look at the details. The benefits you're entitled to may not be enough to meet your needs if you ever develop a condition that leaves you unable to do your job.
Long-Term Care Insurance
Long-term care insurance covers personal and custodial care in various settings, including your home. As the name implies, it provides coverage for long-lasting, sometimes permanent, care.
Long-term care insurance can cover services like home health care that assist with activities of daily living. This helps disabled individuals meet their personal needs, such as dressing, bathing, and meal preparation.
In some instances, long-term care insurance also provides coverage for mental health care. It may, for instance, provide residential treatment at an adult care facility. But this is not a feature of every policy, so consult your insurance agent to find a policy that will provide you with the care you may need (to learn more, see Considering Long-Term Care Insurance? Here's What You Need to Know).
Look into Your Coverage Options
Unlike many of the accidents that send you for an emergency room visit, mental health treatment is usually ongoing and long-lasting. Those costs add up, and many people can't afford to pay them out of pocket. Look into your current coverage and available options and find out how well you're covered if you ever need to avail yourself of mental health services.