As per the official statistics by the World Health Organization (WHO), every 1 in 5 people in the US have a mental disorder. This makes for a staggering 20% of our population, or close to 47 million people. But do you know how many of these people actually seek help? Less than half.
The sky-high costs of mental healthcare and the growing economic divide are prime reasons why more than 50% of people with mental illnesses cannot seek timely professional care. In addition, most patients struggle to get their treatments covered under insurance plans, even though two federal laws have been brought into effect to provide equal coverage of physical and mental health issues. The Mental Health Parity and Addiction Equity Act (2008) and Affordable Care Act (2010) were passed to make healthcare accessible through mental health insurance plans.
However, the laws have only been partially successful in bringing sizeable change. For instance, the laws have ensured that insurance companies are prevented from charging enormous amounts for mental health insurance plans or putting annual or lifetime upper limits to plans. Yet, advocates for patients claim that mental health insurance claims are still more rigorously interpreted than their physical counterparts.
All in all, it is safe to say that finding a good mental health insurance plan is tough and complicated. So let us dive into the most important aspects to sort this tedious process out for you.
What To Know While Looking For Mental Health Insurance Plans
1. Essential Benefits Under the Affordable Care Act (ACA)
The first and most essential part to understand while looking for good mental healthcare insurance plans is to understand the given benefits under the ACA Act, 2008. As per the ACA enactment (2014), small and large insurance providers, including those sold in the marketplace, must cover mental health and substance abuse disorders under their plans. The same is also mandatory for Medicaid alternative plans.
All healthcare insurance providers are required to provide ten essential aids, one of which is mental health and substance abuse disorders. A cognitive and behavioral healthcare plan thus covers:
- psychotherapy, counseling, and other behavioral health treatments,
- inpatient services for mental and behavioral health treatments,
- treatment plans for substance abuse disorders, and
- treatment plans for pre-existing mental and behavioral health conditions.
2. Medicare And Medicaid Coverage
Medicaid, administered and funded by state and central governments, provides health services to American citizens, including all eligible low-income adults, children, persons with disabilities, etc. Every state’s Medicaid program covers a set of mental and behavioral health disorders. While the children’s coverage offers complete services like counseling, therapy, social worker support, etc., the adult’s plan coverage is decided by states.
3. Employer-Based Coverage Plans
All employer-based coverage plans are required to follow the requirements set by Affordable Care Act. The Act also requires insurance providers to write plans in easy-to-understand summaries. Therefore, you must carefully review your insurance plan to understand the benefits it entails and the coverage it provides.
4. Individual Coverage
Suppose you do not have an insurance plan that covers mental and behavioral health issues. In that case, you must learn about insurance services provided through Medicaid, Children’s Health Insurance Plans (CHIP), or Marketplace plans by visiting the HealthCare.gov website. The website created by federal and state agencies allows you to easily compare available coverage and find the best mental health insurance plan.
Mental healthcare is far from accessible in the country. And this is why mental health insurance plans work as a safety net and lifeline offering a wide range of services for affected individuals. However, finding the right mental health insurance plan for yourself is tough. We hope these above-listed aspects will help you navigate the tricky world of insurance providers and help you find the perfect plan for yourself.
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