Posted on September 03, 2019
Not sure if your insurance covers the cost of therapy? Here's a breakdown of common therapy insurance coverage options.
Mental health is just as important to our personal well-being as physical health. Yet, for some reason, finding therapy insurance that covers mental healthcare is more complicated than finding insurance for physical health issues. Fortunately, a law was passed in 2008 to help make finding insurance that covers therapy services less difficult.
Many people aren’t aware of the mental health parity law, also known as the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. In fact, the American Psychological Association took a survey in 2014 and found that 90 percent of Americans didn't know about this law.
So, what’s the mental health parity law and what does it do? In short, this law requires insurance companies to treat mental health services (such as therapy) in the same way that they treat physical health needs. However, this law doesn’t apply to all types of health insurance coverage options.
The mental health parity law applies to employer-provided plans for companies with more than 49 employees, all Obamacare plans, the Children’s Health Insurance Program, and most Medicaid programs. If you have one of these types of healthcare, it’s likely that you have health insurance that covers therapy because of the mental health parity law. Just because your insurance plan doesn’t fall under this law doesn’t mean that therapy isn’t covered.
If you already have health insurance and you want to know whether therapy will be covered, you can look into your plan’s benefit description. Oftentimes, the language in these descriptions can be confusing, so remember that you can always call the company and talk to a representative to check if you can use insurance for your therapy. Advekit can also help (after you get your therapist matches) you can run your insurance benefits in real-time to better understand your coverage details.
Unfortunately, you’re not likely to get a simple answer to whether you have therapy insurance for mental health treatment. All plans are different, and you need to consider factors, such as deductibles, co-pays, and in-versus-out-of-network providers. Due to these factors, there are cases in which paying out-of-pocket for a certain therapist can be cheaper than using your health insurance. These cases are not common, but it’s important to know the specifics of how your plan works and what exactly it covers.
Using insurance for therapy is a great way to get the support you need in a way that’s affordable. On Advekit, you can enter your insurance details in real-time and only pay what you owe in select cities. Advekit bills on your behalf and you don’t need to wait for reimbursement before your next session.
Here are soma other main options you have when it comes to getting mental health insurance coverage:
Employee Assistance Programs, also known as EAPs, are health insurance benefits that are paid for by your employer. Usually, using your benefits from an EAP is free and the care you seek doesn’t need to be work-related. If you have an EAP and the company you work for has 50 or more employees, then your plan falls under the mental health parity law and your mental health treatment will be covered.
Sometimes, EAP benefits are free up until a certain expense amount has been covered. After that, the services you have been getting covered might need to be paid for out-of-pocket. In these cases, your employer might have arranged for discounted care from the same provider that you’ve been seeing. It’s always worth asking if you’re facing out-of-pocket payments for therapy. Also, remember that EAP benefits usually renew each year, so your counseling should begin to be covered again at the beginning of the new year.
Depending on your income and other factors, such as your family situation, you may qualify for health insurance under the Affordable Care Act. Remember, insurance that’s issued through the Affordable Care Act falls under the mental health parity law. This means you’re likely to have solid mental healthcare benefits. You can find more information about whether you are covered through the Affordable Care Act online at www.healthcare.gov.
If you don’t qualify for EAP or Affordable Care Act benefits and you can afford to purchase your own private insurance plan, this is a good option. There are hundreds of insurance plans available, so doing your research is important to be sure that you are getting the right mental health coverage.
If you’re already seeing a therapist and want to continue working with them, you should try to secure a health insurance plan that includes your therapist as an in-network provider. Although, this is unfortunately difficult to do as many therapists are not In-network providers. Using Out of Network coverage is an option, and all therapists are typically considered out of network providers, meaning that once you hit your deductible and if you have OON coverage, you can start to pay less for therapy.
Are you wondering if therapy is really worth the cost? It’s important to keep in mind that seeking assistance from a counselor can drastically improve your overall mental fitness. To find the right match for a treatment plan for your specific needs, contact the experts listed on Advekit.
Alison LaSov, LMFT
Alison LaSov is a Licensed Marriage & Family Therapist with experience treating clients struggling with anxiety and depression. She predominantly focuses on mental health intervention for children and adolescents, particularly those who are in crisis. She has worked within the Los Angeles education system treating students with Individualized Education Plans (IEPs), as well as supervised a non-profit Teen Crisis Hotline out of Cedars-Sinai Hospital. Alison earned her B.A. from UCLA and M.A. from Pepperdine University. She is a native to Los Angeles and co-founder at Advekit.