Therapy is a powerful tool that helps you work through and cope with challenges in life. Knowing what type of mental health services your insurance covers is essential for accessing the best therapist without worrying about costs. Whether you are new to therapy and counseling or searching for new resources to support your mental health, call Online Psychiatrists now. Dr. Zlatin Ivanov helps patients seeking therapy for various reasons, including anxiety, bipolar disorder, depression, eating disorder, and addiction. Even if you don’t have health insurance coverage, he works out options to ensure you get the highest quality mental health care you need to get back to live a healthy and happy life.
Most people delaying getting mental health support because they fear the cost of treatment. Therapy is not cheap, but you can search for what your insurance covers and work on your budget accordingly. You can check with your insurance company and explore strategies for finding the best mental health coverage.
Behavioral health therapy and support for substance abuse disorders are covered by most insurance plans, depending on your plan type. At times, counseling and therapy are not covered by provincial healthcare plans, but there are many options you can explore. You must make efforts to familiarize yourself with the terms of your health insurance plans to better understand what providers and services are available to you.
Yes. You can see a therapist or a mental health professional through your insurance, but there is more to it. It depends on what type of mental help you require and how much mental health coverage you have.
As there are significant and varying differences surrounding the type of insurance benefits provided by insurers, you will have to see how much of your treatment is covered and if there are any out of pockets costs you should know about. A specific mental health condition that has been accurately diagnosed could help determine your access to therapy covered by insurance.
Mental health conditions covered by insurance usually include:
There are laws to protect people diagnosed with mental health conditions to ensure they get the health coverage and mental health support they need to regain their life and well-being.
Read more: What Is Somatic Experiencing Therapy?
Many jobs offer health insurance, but this may or may not include coverage for therapy. You will have to check the healthcare plan of your employer to determine what type of coverage you have through a company plan and if therapy is covered.
Even if therapy is covered by insurance, some people are reluctant to use it for mental healthcare and choose to pay out of pocket. It is because most insurance companies only pay for the medical services that they consider necessary. To prove you really need therapy, you will need an official diagnosis and it is something many people are not comfortable with. They don’t want their sensitive information on record.
This act was established to reduce the cost of health insurance for anyone who wanted it. It offers tax credits and cost-sharing reductions to ensure even low-income families can afford insurance.
It also created a Health Insurance Marketplace and requires plans to cover certain essential health benefits. Plans purchased through Health Insurance Marketplace must include mental health, as well as substance use disorder services.
For mental health, Health Insurance Marketplace must offer:
It is a federal law that keeps group plans from offering different or less mental health benefits than they do medical or surgical benefits. The main objective of MHPAEA and the ACA was to develop a system that offers equal coverage for the treatment of both addiction and mental health conditions.
Before this act, a large population was without insurance. Even people with coverage did not get any mental health benefits, and some plans did not offer substance use benefits.
CHIP provides federal funding to states to help low-income households with low-cost health insurance for children.
While the actual coverage varies from state to state, most plans cover almost all mental health services, including:
Medicaid plans are regulated by the state, and required to cover anything considered an essential health benefit. It includes both substance use services and mental health services.
Medicaid plans also differ from state to state, but they are subject to MHPAEA requirements.
Part A of Medicare covers substance use services and inpatient behavioral healthcare. Also, you may be responsible for deductible and coinsurance costs if you are hospitalized. When it comes to outpatient mental health services, Part B covers many services, including yearly depression screening. You may have to bear the cost of therapeutic services and any Part B deductible, co-pays, or coinsurance.
Part C or the Medicare Advantage typically covers therapeutic services at least at the level of your original Medicare plan or better.
Most Blue Cross Blue Shield insurance plans will cover therapy thanks to Affordable Care Act. People who started their plans before 2014, when the ACA was enacted, may not be able to have their mental health services covered.
It is also important to note that Blue Cross Blue Shield only covers evidence-based services like psychoanalysis. Consultations with a life coach, career coach, etc., are not covered.
Each member of Kaiser Permanente gets a personalized mental health treatment plan with a nurse practitioner or psychiatrist. They offer individual counseling but also cover group therapy. It also offers stress management and mental health classes and addiction counseling as well.
Here are a few simple steps to find out if your health insurance plan covers therapy:
Most insurance plans are available online, and the websites contain information about coverage and related costs. Register your account online and make sure you are looking at your exact insurance plan.
Check out whether you should be looking for a therapist or a provider in your plan’s network or if there are additional charges if you go out of network. If you cannot find the therapist or specialist you are considering, you can call and ask them for the tax ID number they bill with. It can help your insurance provider find them in their system, and you can be absolutely sure you are reaching out to someone within the network.
If you need more information and cannot find it on the website, call the provider. Being a member, you can ask any specific question regarding the types of therapeutic coverage your plan offers. Also ask about the total cost as it will help you decide in case the therapist you want to see is not in your plan’s network.
You can also ask your therapist or doctor about the specific diagnostic code they use when they file your claim. By presenting this code to the insurance company before time, you can know how much of the services will be covered and how much you will owe them, just in case.
If you are insured through your employer and need information, the Human Resources (HR) department can answer any questions regarding your coverage.
It is best to check out with the therapist before starting treatment if they accept your insurance, even if they are listed on the insurance company’s website. It is because therapists and other providers can opt out of plans at any time, so it is better to check before setting up an appointment.
Finding a therapist takes time as you search according to your needs and preference. Doing your homework on payment rates and therapy session limits can make the search easy. It is crucial to find a licensed and board-certified therapist for reliable mental healthcare support.
Read more: Therapist Vs. Psychologist Vs. Psychiatrist: What’s The Difference?
Mental health services and treatments covered by insurance can vary depending on the insurance company and the plan. There are various costs associated with counseling and mental health services. Just checking if insurance covers therapy is not sufficient, and you must find out what type of mental health services and treatment you expect to be covered.
Some of the mental health treatments covered by insurance include:
It is best to check with your employer if you have company coverage, or with the insurance company before setting up any appointments. These days online therapy is also a great option for people who are either hesitant to seek mental health support or cannot make time for an in-person session. Online therapy offers more convenience and flexibility and is also covered by several mental healthcare providers, making it a feasible option.
Insurance can cover therapy in certain cases, depending on your unique situation. Schedule an appointment with Dr. Zlatin Ivanov to discuss your mental health benefits and how you can get the right treatment with your insurance plan. Health insurance coverage is important, and with the right insurance company, you can look forward to some level of coverage for improving your mental health. Dr. Ivanov understands the impact mental health issues can have on your life and comes up with the best treatment and payment options to ensure your long-term mental wellness.
Dr. Zlatin Ivanov, MD, is an adult psychiatrist specializing in addiction treatment, ADHD, anxiety, depression, and OCD. He offers exceptional talk therapy and medication management through online video conferencing.
Dr. Ivanov is double board certified in Psychiatry and Clinical Neurology and a member of the American Psychiatric Association. His medical career is colored by many outstanding contributions to medicine, including several publications, research, and scientific presentations. An attending psychiatrist at Woodhull Medical Center in Brooklyn, NY, and Bellevue Hospital Center in New York City, he takes the time to listen to patients and makes sure they know he is committed to their unique situation.
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