When Does Health Insurance Cover Therapy?

​While psychotherapy is widely accepted as an effective method for treating mental health issues, not all insurance plans cover it similarly. Fundamental beneficial properties, such as the availability of medical necessity procedures, are typically included in current health insurance policies. 

However, non-marketplace policies are not mandated to comply with the standards of the Affordable Care Act's Marketplace.

Limitations of Therapy Coverages
The Parity and Addiction Equity Act prohibits psychological health insurance policies from having less coverage than medical and surgical policies. If your coverage covers mental health treatment, your insurer cannot limit therapy costs.

Insurance only covers medically required care. Even if your insurance covers mental health, counseling without a psychiatric diagnosis is unlikely to be reimbursed.

When Does Therapy Get Paid For?
Coverage and provider determine medications, treatments, and specializations. Psychotherapy is reimbursable. Insurance covers treatment. Insurance must fund therapy under the 2008 Mental Health Parity Act.

Medicare
To qualify for Medicare, one must be 65 or older. You can also use it if you have an end-stage renal illness or are a younger impaired person. Initiatives concerning Medicare are plentiful. Medicare B includes coverage for outpatient mental health services. 

Alternative (A) is best because it pays for healthcare services. Medical care, including visits to the doctor and the cost of medications, is paid for by both plans.

Medicaid
People with limited earnings can qualify for Medicaid. The requirements for participation differ from state to state, but the online application procedure is uniformly simple. Medicaid provides coverage for a wide range of medical services, including emergency response and long-term treatment for mental illness.

Employer-Sponsored 
Medical insurance that includes mental health care is a legal requirement for any company with more than fifty employees. Employers may choose to provide coverage from large businesses. Services offered by larger and smaller businesses are typically on par.

Ensure Your Mental Well-Being is Protected
Having health insurance, however, can be the difference between being treated and going without. Studies show that 72 percent of people with mental illness have at least one barrier to treatment, such as financial concerns or lack of health coverage. 

At Hayek Insurance, we do our best in making sure that our clients are well-protected with affordable and comprehensive policies. We make sure to go the extra mile to help you with your needs. To learn more about how we can help you, please contact our agency at (805) 496-8835 or Click Here to request a free quote. Topics and coverage discussed in this article are not guaranteed, consult with your agents to determine what your policy does and does not cover. We are more than happy to help!