With the prevalence of mental health issues in our society, it is important to ensure that therapy is accessible and affordable for everyone. If you’re wondering whether your insurance covers therapy, you’re not alone. Many people have the same question. In this article, we’ll explore different options and shed light on what therapies are typically covered by insurance.
Does Insurance Cover Therapy?
The coverage for therapy depends on your insurance plan and provider. Fortunately, the Mental Health Parity Act of 2008 ensures that many insurance plans include therapy. Here are some types of insurance that often cover therapy:
Companies with more than fifty employees are required to offer health insurance that includes mental health services. This coverage may be provided by large companies like Anthem Blue Cross Blue Shield, Kaiser Permanente, Cigna, Aetna, or United Healthcare. Even smaller companies often offer excellent coverage.
Medicaid is available for low-income individuals and families. The eligibility requirements vary by state, but applying is usually straightforward. Medicaid covers a range of physical and mental health benefits, including crisis intervention and psychiatric rehabilitation.
Medicare is available for people aged 65 and older, as well as those with end-stage renal disease and disabilities. Mental health services that do not require hospital visits are covered by Medicare Part B, while Part A covers hospitalization. Both parts also include prescription drug coverage.
Children’s Health Insurance Program (CHIP)
Focusing on the mental health needs of children is crucial. CHIP is designed for families with children who earn too much to qualify for Medicaid. Some states also provide coverage for pregnant women.
Insurance Purchased through the Affordable Care Act Marketplace
For those whose income exceeds Medicaid eligibility or for adults with children needing coverage, insurance purchased through the ACA Marketplace is an option. Long-term plans under ACA cover pre-existing conditions and offer consistent coverage.
Types of Treatment Typically Covered by Insurance
Insurance plans generally cover the following mental health needs:
- Outpatient treatment
- Prescription drugs
- Emergency care
Specific services may vary based on age groups, state offerings, and other criteria. It’s important to check the details of your insurance plan to see what is covered.
Therapists, Counseling, and Psychiatrists
Therapists, including talk therapists, are typically covered by insurance. Counseling is also covered, although couples counseling may not always be included. Psychiatrists, who provide therapy, refer patients to psychologists and counselors, and prescribe medications, are covered as well.
Exceptions to Coverage
It’s worth noting that certain non-traditional therapies like hypnotherapy may not be covered by insurance. Additionally, some insurance companies may not cover personal growth topics or niche methodologies.
Pros and Cons of Insurance-Covered Therapy
Choosing therapy covered by insurance has its advantages and disadvantages. Let’s explore them:
- Lower costs: Insurance significantly reduces copays, potentially eliminating out-of-pocket expenses.
- No surprises: With insurance, you know you’re covered regardless of the severity or frequency of therapy needed.
- Less research: In-network therapists are conveniently accessible.
- Limited options: If your desired therapist or preferred type of therapy is out-of-network, it may be worth considering paying out-of-pocket.
- Pre-existing conditions: Using insurance for therapy may be recorded in your insurance history, potentially affecting future coverage.
- Schedule constraints: In-network options may not always align with your schedule, prompting you to explore out-of-network alternatives.
How to Determine if Your Insurance Covers Therapy
To find out if your insurance covers therapy, consider the following steps:
- Ask your insurance provider: Reach out to your insurance provider through their website, phone, or contact form. They can provide you with the information you need.
- Contact the therapist’s practice: Get in touch with the therapist’s practice directly to inquire about their accepted insurance plans. Their website or contact information should have this information readily available.
Eden Health is dedicated to helping employees with their mental health needs. Our team of licensed therapists covers a wide range of mental health concerns, from anxiety to grief counseling and more. Additionally, our doctors routinely screen for mental health issues during every primary care visit.
As a direct employer medical provider, Eden Health collaborates with various insurance providers to offer top-notch physical and mental health services to your valued team members. Our seamless integration with any health or insurance plan ensures that your employees receive the quality healthcare they deserve.
If you want to learn more about our collaborative care model and how it can address the needs of your employees, request a demo with a member of our team today.