Does insurance cover therapy?
with about a fifth of the us. uu. population living with mental illness, everyone probably knows someone who goes to therapy. anxiety disorders, for example, affect more than 18% of the adult population and more than 25% of adolescents. Treating mental illnesses the same way we treat physical illnesses allows us to be completely healthy. And to properly treat mental health problems, whether short-term or long-term, we need to know: Does insurance cover therapy?
does insurance cover therapy?
Specific treatments, methods, specialties, and offerings depend on the patient’s insurance plan and provider. So is the therapy covered by insurance? yes, many providers cover therapy. According to the Mental Health Parity Act of 2008, the following insurance plans include therapy:
Companies with more than fifty employees are required to offer health insurance that includes mental health services. Employers may provide coverage from large companies, such as Anthem Blue Cross Blue Shield, Kaiser Permanente, Cigna, Aetna, or United Healthcare. many smaller companies also offer great coverage.
low income people are eligible for medicaid. each state has different eligibility requirements, but the website makes it easy to apply. Medicaid includes a variety of physical and mental health benefits, such as crisis intervention and psychiatric rehabilitation.
Medicare is for people age 65 and older. it can also be for those with end-stage renal disease and youth with disabilities. there are several parts of medicare. Medicare Part B covers mental health services that do not require hospital visits. Part A covers hospitalization. both parts include prescription drug coverage.
children’s health insurance program (chip)
It is crucial to address children’s mental health needs as they arise. chip is designed for families with children whose income is too high to qualify for medicaid. may also provide coverage for pregnant women in some states.
Insurance purchased in a marketplace under the Affordable Care Act
This could be a good option for people whose income is too high to qualify for Medicaid or who have adult children who need coverage. ACA long-term plans will cover people regardless of pre-existing conditions and won’t increase the cost for it. Plus, coverage won’t suddenly run out.
Explore the marketplace, also called an exchange, to see what plans are available for different regions and needs. Please note that enrollment in a new plan through the Marketplace can only be done during open enrollment periods. certain states have different websites for their health coverage.
types of treatment normally covered by insurance
At a minimum, insurance generally covers the following mental health needs:
- outpatient treatment
- prescription drugs
- care in case of emergencies
Other plans may offer more specific services tailored to specific age groups, state offerings, and other criteria.
Are therapists covered by insurance?
yes. This includes talk therapy for mental illness, including anxiety disorders, the most common mental illness in the United States.
Is counseling covered by insurance?
yes. however, couples counseling may not be covered. insured patients should check with their providers.
Does health insurance cover a psychiatrist?
yes. psychiatrists can offer therapy, refer patients to psychologists and counselors, and prescribe medication.
Please note that some non-traditional options, such as hypnotherapy, are not typically covered by insurance. Also, personal growth topics and niche methodologies may not be covered by most insurance companies.
pros and cons of using insurance-covered therapy
It may seem like a no-brainer to use therapy covered by insurance. in many cases, it is. But there are pros and cons to choosing in-network practices and treatments.
- lower costs. having insurance dramatically reduces copays for therapist visits, which can add up over time. insured patients may end up paying nothing out of pocket.
- no surprises: insured patients know they’re covered, no matter how often they use it or how serious their mental health problem is.
- Using insurance-covered therapy requires less research for the patient—just go to the in-network therapist that’s most convenient for you.
- Sometimes, if a desired type of therapy or a specific therapist is out of network, it may be worth not using insurance.
- will be placed on the insurance record of the patient requiring therapy. To avoid being classified as having a pre-existing condition, paying out of pocket may be a better option.
- If in-network options don’t work with a patient’s schedule, going out-of-network may offer more convenient options.
- ask your insurance provider in person or by phone or contact form. the answer may also be on your website.
- ask the therapist’s practice in person, by phone, or by email. the answer may also be on your website.
if money is not an issue, ask “does insurance cover therapy?” might not matter here are a few more reasons why insurance shouldn’t dictate your choice of therapist:
How do I know if my insurance covers the therapy?
When you ask “does my insurance cover therapy?”, you want a quick and clear answer. If it’s still unclear if your therapist accepts your insurance, here are some steps to take:
eden health members can get answers to their insurance coverage questions by talking to a healthcare navigator through the app.
does insurance cover therapy? the end result
eden health is here to help when your employees need a therapist for their mental health needs. our team of licensed therapists can address a variety of mental health needs, from general anxiety to grief counseling and more. our doctors also screen for mental health issues at every primary care doctor visit.
eden health works with many insurance providers to provide companies with the best physical and mental health services for the employees of their valued team members. As a direct employer medical provider, we offer a new collaborative approach to employee health. Plus, we can integrate with any health or insurance plan, making it easy for you to provide your employees with the quality health care they deserve.
Want to see how our collaborative care model works to address the physical and mental health needs of your employees? Request a demo with a member of our team today.