Quick Look: Best Mental Health Insurance
One in every 5 Americans suffers from some form of mental illness — that’s more than 65 million people, according to data from the National Alliance on Mental Illness (NAMI).
Unfortunately, many Americans living with mental illness don’t seek treatment to help manage their conditions. Only about 41% of those living with mental illness receive treatment or counseling for their mental health.
Health insurance policies that place increased emphasis on mental health coverage can make seeking treatment for your mental illness easier and more accessible than relying on free or low-cost community services. We’ve created a guide to help you shop for mental health insurance and included information on our favorite mental health insurance providers.
Best Health Insurance Policies that Cover Mental Health
As we covered before, every ACA-approved health insurance plan will afford coverage for mental health services.
1. United Healthcare
United Healthcare’s website offers a host of tools and resources that you can use as a preliminary screening tool if you’re concerned about your mental health. Behavioral health benefits from United offer 24/7, confidential support for symptoms of depression, anxiety, psychiatric disorders, PTSD and more.
If you have a physical disability that makes movement or driving difficult, United also offers you access to a series of “telemental health care providers” who offer diagnostic services via video conference.
United’s behavioral health benefits even include treatment options for problematic gambling and compulsive spending habits, two addictions that aren’t included under the ACA’s list of substance abuse disorders.
If you haven’t yet been diagnosed with a mental illness but you’re still interested in exploring anger or medication management solutions, United Healthcare also has options that can get you started on the path to healthier habits. With insurance options in most states and mental health benefits that are above federal minimums, United Healthcare is our top choice for those struggling with mental illness.
2. Kaiser Permanente
Kaiser Permanente currently offers insurance plans in only 9 states. The health care provider offers a wide range of mental health protections and its website features a large body of information.
You can use it to learn more about what to expect from your first psychiatric appointment, common misconceptions about mental illnesses, stress management tools and much more.
Kaiser Permanente offers personalized treatment options, and you can quickly search for a local provider using its zip code search feature.
Kaiser Permanente doesn’t require you to get a referral from your doctor to see a mental health specialist like a psychiatrist. No matter which treatment option you’re interested in, chances are that Kaiser Permanente has a supported option and solution for you.
Aetna offers employer, Medicare and Medicaid plans. Plans from Aetna offer an increased emphasis on mental health, which makes them attractive for employers who work in a high-stress environment.
Aetna’s website features a number of mental health screening tools, and its search feature makes it simple to find doctors, therapists and psychiatric professionals in your area.
What Health Insurance Companies Can Cover for Mental Health
The Affordable Care Act expanded mental health insurance coverage and set minimum essential benefits that every health insurance provider needs to offer on all long-term plans.
A few portions of the original Affordable Care Act (ACA) have been repealed, including the individual mandate that requires every American to maintain some form of insurance or pay a fee. However, the essential benefit protections remain in place. Your health insurance provider must cover the following essential mental health services:
Substance Abuse Treatments
Addiction is defined as a disease by the Center for Disease Control, and your health insurance provider must offer coverage for substance abuse treatment. Substance abuse disorders include alcoholism and drug dependence and can seriously impede your ability to find and keep a job, care for dependents and more.
Substance abuse treatments monitored and administered by a medical professional can help you reduce your dependency on drugs or alcohol.
Common substance abuse treatments include:
- Inpatient therapy: Specialized medical therapy and treatments administered in a hospital.
- Residential treatment: Sometimes referred to as drug or alcohol “rehab.”
- Partial hospitalization treatments: You spend 4 to 8 hours a day under medical supervision but return home.
- Intensive outpatient treatments: If you have an addiction to opioids or barbiturates, your insurance may also include methadone clinic treatments to help you safely manage withdrawal symptoms.
In addition to substance abuse treatment and therapy, your doctor may prescribe medication to help you manage your symptoms. Prescription drugs are often used in conjunction with therapy to treat mental illnesses like anxiety, depression, schizophrenia, attention deficit disorder (ADD) and obsessive-compulsive disorder.
Prescription refills may be prescribed by your general practitioner, but most doctors will refer you to a specialized mental health physician called a psychiatrist for an initial diagnosis and prescription.
Prescription drugs are often categorized into tiers by insurance companies depending on how much they cost. Most insurance providers use a five-tier ranking system to categorize drugs. Tier 1 consists of the least-expensive generic prescription drugs and medications, while Tier 5 contains brand-name, highly specialized (and often very expensive) drugs.
Therapy can be used to help identify the underlying causes of mental illness, phobias and self-sabotaging behaviors.
A therapist’s goal is not to tell you what you should and shouldn’t do, but instead, guide you through thought exercises to help you think about problems differently, manage symptoms and change your behavior. Some of the most common types of therapy include:
Psychotherapy involves talking through problems, stressors and triggers with a professional therapist to uncover strategies to manage symptoms and monitor your condition. You and your therapist may discuss trauma, events from your childhood and your interpersonal relationships and examine them.
Cognitive Behavioral Therapy
Cognitive behavioral therapy involves confronting negative patterns of self-thought and self-abuse and challenging them. A cognitive behavioral therapist may help you manage symptoms of anxiety or depression by helping you learn coping strategies to break out of negative thought patterns.
Behavioral therapy is similar to cognitive behavioral therapy but focuses on specific, learned behaviors and the effects that environments have on those triggers. Behavioral therapy is used to treat anxiety, PTSD and obsessive-compulsive disorder.
If you have severe depression or mania that hasn’t been improved or alleviated with other forms of treatment, your psychiatrist may suggest electroconvulsive therapy. During electroconvulsive therapy, a surgeon will pass small electrical currents through the brain to intentionally trigger a brief seizure.
Electroconvulsive therapy is performed under general anesthesia, so patients aren’t awake or feel any pain during the procedure. The seizure resets certain areas of the brain’s chemistry and allows the patient to see sudden and drastic changes in their mental health.
Though early versions of electroconvulsive therapy became infamous for administering too-high electrical current, today’s procedures are significantly safer.
However, electroconvulsive therapy is still riskier than other forms of treatments like talk therapy and medications, so it’s usually used as a last resort when other treatment options fail. Your insurance provider and psychiatrist will require you to attempt treatment with alternative measures before you consider electroconvulsive therapy.
Typical Reimbursements and Copays for Mental Health Coverage
Thanks to the Affordable Care Act, mental health services are considered essential benefits. Your insurance provider may not charge you a separate or higher deductible or copay for mental health services, nor can they put a limited dollar amount on how much coverage you can get for these services.
Limits on which mental professionals and treatments cannot be more restrictive than limits on other services, like prescription drug coverage or surgical services. Your insurance provider cannot deny you coverage due to a preexisting mental health issue or illness and cannot limit your benefits if you choose to begin seeking treatment.
Note that these protections are only afforded to long-term, ACA-approved insurance plans. If you purchase a short-term or catastrophic plan, your insurance provider can institute strict limits on mental health coverage or may cut mental health services altogether. If you need mental health services, only use non-ACA-approved plans as a last resort and make sure to thoroughly read each policy to make sure you get the coverage you need.
The specific amount you pay in a yearly deductible and copay depends upon a number of factors, including whether you opt into employer-sponsored health insurance or buy a Marketplace plan, your age, whether or not you smoke and the number of dependents on your plan.
The average American pays about $1,500 in annual deductibles for single coverage and about $2,800 for family coverage. Copays for mental health therapy are usually paid per visit and may range from $25 to $50 per session. You can expect to pay a higher copay for psychiatric services.
Features of Great Companies for Mental Health Insurance
When you compare health insurance policies, keep an eye on mental health protection and looking for the following features.
Mental health practitioners you trust. If you’re already seeing a behavioral therapist or psychiatrist, it can be distressing to find another professional you trust. Look for health insurance plans that your doctors accept or choose a PPO plan which can give you more freedom to see medical service providers outside of your network.
Prescription drug coverage. Have generic mental health drugs failed you in the past? If so, choose a provider who offers immediate coverage for brand-name prescriptions without first attempting to switch to the generic version. If you aren’t sure which tier your medication is on, you can use Healthcare.gov’s prescription drug coverage finder tool to see a list of plans that include your medications.
Availability in your state. Not every health care provider can issue insurance in each of the 50 states. Make sure your plan provider is authorized to sell insurance in your state through your state’s Marketplace before you commit to a plan.
Securing Support for Mental Health
Every year, millions of Americans seek mental health services to help combat symptoms of mental illness. If you or someone you love is hesitant to see a psychiatrist or therapist, local support groups or online forums are a great place to begin working up the confidence to talk to your doctor.
Frequently Asked Questions
Does Medicaid cover therapy in Michigan?
Medicaid will cover counseling for mild mental health conditions in Michigan.
About Sarah Horvath
Sarah is an expert in the insurance, investing for retirement and cryptocurrency space.