Home Mental Health & Well-Being Do Insurance Companies Normally Cover Mental Health Issues?

Do Insurance Companies Normally Cover Mental Health Issues?

Published: Last updated:
Reading Time: 3 minutes

Mental health and physical health are crucial to our well-being. However, some insurers don’t view it the same way. Many health insurance companies would provide better coverage cases involving physical illness than mental disorders in the past. However, the Mental Health Parity passed in 2008 requires equal coverage of both physical and mental health conditions. 

Provisions of the Parity Law

Most insurance policies provide mental health coverage, but the only difference was that these cases were treated differently from other medical issues in the past. The federal parity law applies to different types of insurance that include the following:

  • Employer-sponsored health policies
  • Policies purchased through health insurance exchanges
  • Most Medicaid programmes
  • Children’s health insurance programme

You should carefully check the benefits of your plan so that you get insight into what it covers and what it doesn’t cover. The federal Parity Law requires that all insurance companies must treat both mental and substance use disorder coverage equal to medical coverage. All the financial requirements for medical and mental related cases should be treated equally. For instance, the copay for an office visit to a medical health professional should be the same as the copay charged for an office visit to a mental health professional. 

The Parity Law also eliminates the non-financial treatment limits concerning the number of mental visits that one is allowed per year. These limits were once common before the enactment of the parity law, but they have since been barred. However, the law does not prohibit the insurance provider from implementing limits that are related to medical services.  

How to get the right medical plan 

Various medical insurance companies provide policies with several benefits that are designed to suit the needs of different people. It is imperative to check the benefits offered by a particular plan before you buy. The policy should include details on coverage of mental health disorders and behavioral health services. The insurance brokers at Insurdinary.ca explain that apart from benefits offered, you must also compare rates to save money on insurance. You should use the right tool to get multiple quotes from different insurance providers so that you get an affordable medical plan that suits your needs. 

How about a policy with no medical benefits

If you already have a medical insurance plan that does not have mental health benefits, the insurance provider would not be violating any law. The parity law does not require all insurance providers to offer mental health benefits. Instead, the law states that whenever mental health benefits are offered, they should not have restrictive requirements compared to physical health benefits. Many large group policies have already been providing health benefits before the promulgation of the parity law, but the only difference was biased coverage. People with mental cases were often treated unfairly. 

Does a health plan cover therapy?

You need to do some research to establish if your health plan covers therapy. The policy should spell the mental health benefits, or you can visit the health plan’s website. Insurance does not cover all forms of therapy, and this is why you must get finer details about your policy. In some cases, the mental health provider might need to get a diagnosis for conditions like depression or panic disorder before they provide therapy. However, this can affect your future visits to the physician. 

Pre-existing mental conditions

If you have any pre-existing mental conditions, the marketplace plans cannot deny you coverage for that. Additionally, the insurance provider cannot charge you more because of your pre-existing condition. The day your policy coverage kicks in, you can get treatment for all the pre-existing conditions that you might have. The marketplace plans cannot put limits on coverage of different essential health benefits that include mental health. 

Mental health is just like physical health, but some insurance providers have been treating the two differently until recently. Following the passing of the Parity law and Affordable Care Act, all insurers should not discriminate against people with mental related conditions. The copay for mental care visits and surgery visits should be similar. The other important thing that you should know about your policy is to understand its inclusions and exclusions before filing a claim. It does not mean that the inclusion of mental illness makes the insurer liable for insuring people with pre-existing mental conditions. The insurance company cannot reject a claim of someone diagnosed with a mental illness after buying a policy. 

Elena Deeley did her degree in psychology at the University of Edinburgh. She has an ongoing interest in mental health and well-being.

© Copyright 2014–2034 Psychreg Ltd