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Can Health Insurance Cover Therapy and Other Mental Health Treatments?

According to the National Alliance on Mental Illness, almost one in 25 adults experiences a severe mental illness that interferes with major life activities each year. If you are among them, you might be worried about whether health insurance covers therapy or other treatments. Health insurance covers therapy and mental health.Fortunately, health insurance increasingly covers mental health as well, which includes psychological, social, and emotional well-being at all stages of life. Recognizing that good mental health is as significant as physical wellness, federal law has greatly expanded insurance coverage for mental illnesses.

The 2008 Mental Health Parity and Addiction Equity Act states that if employers provide mental health insurance benefits, they cannot have more restrictive requirements than those that apply to physical health benefits. That means that if your insurance needs a $20 co-pay for most physician’s visits, you’d owe a similar copay when seeing a psychologist.

According to the American Psychological Association (APA), most large group health insurance plans offered mental health benefits before the parity law took effect.

Under the Affordable Care Act, which was approved in 2010, all health insurance plans sold on insurance marketplaces must cover mental health and substance abuse services as essential health benefits. These health insurance plans must cover:

• Behavioral treatments, like psychotherapy and counseling
• Inpatient services for mental and behavioral health problems
• The treatment of substance use disorders

The trend of providing mental health benefits to the insured extends to most employer-provided health insurance plans, which don’t have these federal requirements. In a 2015 study, the Society for Human Resource Management found that only 9% of employers’ health plans do not extend mental health treatment benefits to workers. There are some plans that are exempt from the parity rule, nevertheless.

According to the APA, companies with less than 50 employees do not have to follow the parity rule. Medicare is not subject to the federal parity law. Likewise, some state government employee plans, including those that cover state university workers and teachers, may opt-out of parity requirements.

How Health Insurance Applies to Mental Health

According to HealthCare.gov, you have the right to an easily understood summary of your health insurance plan. Health insurance companies and job-based health plans must offer you a short, plain-language summary of benefits and coverage. They also must offer a glossary of health insurance terms to help you understand your coverage.

To learn how your health insurance plan applies to therapy and mental health treatment, read the summary of your policy. The APA says the description of benefits should comprise information on behavioral health services or coverage for mental health and substance use disorders.

If it does not appear that you are covered for mental health issues, contact your insurer to be certain.

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References and Resources

• Employee Benefits
• The Affordable Care Act