Know Your Coverage

Know Your Coverage

Insurance Coverage for Mental Health Care

Insurance coverage for mental health problems is changing -- for the better. In the past, your insurance might have paid 80% of the cost of seeing your primary care doctor but only 50% of the cost for seeing a psychologist. But a law that took effect in 2010 changed the rules. Under the law, if a private insurance plan provides coverage for mental health and substance use services, the plan's coverage must be equal to physical health services. For example, benefits must have equal treatment limits, such as: Number of days you can stay in the hospital, How often you get treatment, also, the amount you pay on your own needs to be the same for similar categories of physical and mental health services. 


Before Your First Appoint,  "Flip Your Card and Call" your insurance provider. There should be a customer service number, for you to call and ask the following:

  • Out-of-pocket maximums (the total amount you have to pay)
  • Co-payments (a fixed amount you pay for a health care service)
  • Co-insurance (your share of payment for a health care service)
  • Deductibles (the amount you have to spend before your insurance company starts to pay)

If your health insurance covers some or all of the cost of going out of network for a physical health problem, it has to do the same for a mental health problem. If you see a mental health provider and do not have insurance you are legally liable for any and/or all the costs, so that is why it is so important to know. Hope this help!

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