The best way to start a discussion on mental health coverage is with a clear definition just to ensure that we’re all working with the same base understanding of what your insurance providers can do for you if you need help with regards to your mental well-being:
A Definition of Mental Health Coverage
Mental health coverage consists of the treatment provided by a health insurance company to their customer base in order to help with issues pertaining to mental health. This could include the medication prescribed to a patient with a chemical imbalance or the therapy that empowers them to get better. It varies from patient to patient, problem to problem, but in general, the law dictates that rules regarding the co-payments, deductibles and maximum payments all must match up with the same provided for physical health.
A Legal Definition of Mental Health Issues
In the state of California, some issues are covered under mental health while others are not. To provide a brief listing of what is legally covered under your health care provider in this state if they offer mental health coverage:
– Major depression
– Bipolar disorder
– Panic disorder
– Anorexia and bulimia
– OCD or Obsessive Compulsive Disorders
– Autism and pervasive development disorders
– Schizophrenia and schizoaffective disorder
– Severe emotional disturbances in children
Your own health insurance provider may show you a very different list for what is covered, but the above listed issues are the legal bare minimum of what a provider must cover in order to say that they offer mental health coverage.
Notice that there is a lot missing from this list. You’re not likely to find a health insurance provider who will cover something like aromatherapy or a trip to the spa to reduce stress as a mental health issue. What they’re looking for is a serious disorder, real anxiety or depression, before they’re going to step in and cover any of the costs involved in treatment.
Getting Covered
So far we’ve told you what you can and can’t expect from your health care provider, but the question still remains as to how you get covered in the first place.
1. Policies that Cover Mental Health
Besides full health coverage plans, one way to be covered is through a comprehensive disability plan. Disability health insurance will usually cover the diagnosis of mental illness regardless of age and emotional disturbance in children. Providing that your disability insurance covers hospital, medical and surgical costs, you should be covered for mental health diagnosis and medically necessary treatment, as well.
2. Qualifying for Mental Health Insurance Coverage
There are a lot of different ways in which to get covered by a policy that covers your mental health. Here are just a few:
– Employee groups of 2 or more people
– Managed care health insurance
– Traditional indemnity insurance
– Government health insurance including Medicaid and Medicare
Failing all of that, there is always the option of paying out of pocket for those who have the income to do so.
Every one of these options will look more or less attractive depending on your own personal station in life. Clearly, employee health insurance is preferred if you are looking to save money and have a job that covers you, managed care can keep costs down, traditional indemnity offers costs based on services rather than provider, and government health insurance may provide you with fewer options regarding who to take on as your health provider, but nevertheless, it’s there for you as a last resort.
Government programs like SSI can help people who are poor or otherwise unable to provide for themselves to get the mental health care that they need to live a happy, healthy, productive life. If this is you, you will want to visit socialsecurity.gov to get started on the road to wellness.
The Importance of Mental Health Coverage
There is an unfortunate idea floating around in today’s society that mental health problems are something you just need to “get over,” that it’s not a real health concern. The fact of the matter is that schizophrenia, depression and emotional trauma are as real as the flu or a broken leg. If you feel that you may be suffering from an emotional or mental disorder, it is of the utmost importance that you do everything in your power to get the treatment that you need.