What Mental Health Services are Covered by Insurance?

Health insurance can be tough to navigate. People have a lot of questions about their coverage, including: 

A lot depends on what type of health insurance you use. For example, if you got your insurance through the healthcare marketplace, the company is required to provide mental health services. 

Likewise, all U.S. health insurance companies must treat mental health services and physical health services equally. 

However, according to the American Psychological Association, this does not mean that non-marketplace insurance companies must provide mental healthcare. It means that when a company does cover mental healthcare, it cannot treat mental and physical care differently. 

For example, copays for mental health specialists and physical health specialists must cost the same amount. 

Many American health insurance companies, even companies outside of the marketplace, offer mental healthcare coverage. 

Coverage varies from one company to the next, but you can check your provider’s website for more information. In general, here are some mental health services that are commonly covered by insurance providers. 

Drug and Alcohol Addiction Treatment 

Many insurance companies cover drug and alcohol addiction treatment. Some examples include inpatient rehab, outpatient rehab, detox, and scheduled therapy. 

Insurance companies may cover different lengths of treatment, though. For example, while some rehab centers may offer inpatient treatment for up to 90 days, many insurance providers only cover the first 30. 

Evidence-Based Therapy Appointments 

Some insurance companies provide limited coverage for experimental or holistic treatments. 

Experimental treatments are treatments that show promise but have not been proven yet. 

Holistic healthcare includes treatments that incorporate mental, physical, and spiritual techniques. It can include options such as massage, yoga, acupuncture, and several others. 

Many companies do not cover these treatments, but most cover evidence-based therapies. These are therapies that have been proven helpful based on scientific study. 

Cognitive behavioral therapy, for instance, is often covered by health insurance. 

Insurance providers may offer varying amounts of coverage. For example, they may cover a specific number of appointments per year. 

Testing and Diagnosis 

Some mental health diagnoses, including those for personality disorders and neurodevelopmental conditions, require an extensive testing process. Often, this process is covered by health insurance providers.  

Providers may be very selective about the types of tests that they cover. Some may only cover what they deem strictly necessary. 

For example, an IQ test is sometimes included in the ADHD diagnostic process. While this test can help doctors spot learning disabilities, it is not necessary for diagnosing ADHD itself. For that reason, many health insurance companies don’t cover that part of the process. 

How to Pay for Services without Coverage 

Health insurance companies can offer a lot of coverage, but what if you need services that your provider doesn’t offer? 

Even if you have limited coverage, you still have options. Look into the choices below if you need mental health services. 

    • Use what is offered. For example, if you want to attend inpatient rehab for 90 days, but your insurance only covers 30, use the available coverage. Thirty days of treatment is better than no treatment, and you may have options to pay for the other 60. 
  • Ask about a sliding scale. Some mental health professionals offer lower rates depending on the patient’s financial needs. 
  • Look into payment plans. Monthly payment plans can help patients who cannot pay for services upfront. 

Mental health is just as important as physical health. As more people realize this fact, more options become available. If you need mental healthcare services, understanding your options can help you find the care you deserve. 

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