Health Insurance and Mental Health, by Ben Roberts

Health Insurance and Mental Health

Health Insurance and Mental Health, by Ben Roberts

I am currently 24 years old, and as I have transitioned into adulthood, one thing that I have yet to be able to fully understand is how health insurance works. I wrote this article as I attempted to understand mental health and how it works with my insurance.

If you were to Google “Health Insurance Horror Stories”, there are 19,600,000 results that appear. Across the world, there are different health insurance systems in different countries, and all of them have their own unique problems. Here in the United States, medical bills are the #1 cause of bankruptcy. In 2016, we spent $3.3 trillion dollars on healthcare. About 49% of Americans get their health insurance through their employer, 19% through Medicaid, 14% through Medicare, 7% through non-group plans, and 2% through public insurers. 9% of Americans are uninsured. There are over 900 health insurance companies. Trying to understand the terms “deductibles”, “out of network”, “HSA’s”, “out-of-pocket maximum”, “premiums”, and so many more can be a headache. On top of it all, understanding if mental health care is covered under your plan, and to what extent, can be a whole other headache itself.

My Personal Experience Trying to Understand Mental Health Insurance Coverage

I decided to do some research to try and understand how mental health works with health insurance and how much it might cost me to get mental health treatment. I have not done research on this before and have not received mental health treatment before. These were my findings after trying to do this for the first time.

First, I went to my healthcare website. Since I am 24, I am still on my parent’s plan, which happens to be Regence Health Care. I signed in and went to a tool that they have that allows me to find doctors near me that specialize in the treatment I am looking for. Then I found a few that were in-network that were close by so that was a good start. Next, I went to a tool that they have, which is supposed to estimate my costs. I could not find anything around mental health, counseling, or therapy, so I am unsure of what this would cost me. I can see my deductible, my annual out-of-pocket maximum but no signs of whether mental health would be covered or discounted at all through my insurance.

After searching around the website, I decided to type in “mental health” on the search bar. I got a message saying, “No Results for “Mental Health” – Check your spelling or try a more general term.” I am not sure what could be more general than mental health, so I concluded that there was nothing on my insurer’s website about my current mental health benefits. I decided to ask around and look online more to see what I could find.

A woman sitting on a couch using a computer

General Information

What I was able to gather from researching online is the following: 

  • The Mental Health Parity Law was passed in 2008 and requires coverage of services for mental health, behavioral health, and substance abuse disorders. The law requires insurance companies to treat mental and behavioral health coverage equal to medical/surgical coverage. This law affects employer-sponsored health coverage, coverage through health insurance exchanges, children’s health insurance programs, and most Medicaid programs.
  • The parity law does not require every insurer to have a mental health benefit plan, but that there cannot be more restrictive requirements than those that apply to physical health benefits. The Affordable care act does require that plans offered through the health insurers exchange cover services for mental health.
  • There is a single deductible for physical and mental health benefits. Once your health plan deductible is met, your insurance company should reimburse you for your expenses.
  • Insurance companies cannot limit the number of mental health therapy sessions per year, but they can manage your care. This means that after a certain number of visits they can evaluate your case to see if additional treatment is necessary.
  • Something important to remember is that certain mental health providers do not accept insurance. Just because you have health insurance and it covers mental health treatment, does not ensure that you will be able to use it with certain providers.

Understanding Your Own Mental Health Insurance Coverage

The best path in figuring out if your mental health treatment will be covered by your insurance company is to call your mental health service provider ahead of time and check with them to see if they take your insurance. Then, check with your insurance to see if they cover mental health-related treatments and to what extent. You can ask questions like, how much will this $130 therapy session cost me after insurance? Though it may be time-consuming and sometimes frustrating, it is best to talk directly to the provider and insurer to try and understand the situation.

Tips:

  1. Figure out which mental health providers are “in-network”. This can be done through your insurance company’s website or by calling them and asking them.
  2. Ask about copayments. Insurance companies require you to pay out-of-pocket copayments for certain services. Even if the treatment is covered under your plan, you may be required to pay a copay every time you visit.
  3. Understand your deductible and whether you have reached it or not.
  4. Ask the provider about their payment policy, and if they will bill the insurance company or if you need to pay in full then submit a claim.

Is cost the only thing holding you back from getting the help you need? Or maybe it is currently costing you an arm and a leg. Whatever your situation is, reach out to your health insurance company and see what benefits are available for mental health.


Ben Roberts, Director of Community 

Ben enjoys helping people become their best selves and enjoys working to help solve problems around mental health to ensure that people can live fulfilling lives. He joined the Overt Foundation in April of 2019 and works to help ensure that things run smoothly and that people are getting the help they need. 


If you or anyone you know is facing mental health challenges and needs support, we can help you.

You can share how you’re feeling or about your experience, or apply to our subsidized therapy program.

2020 Presidential Election Candidates' Mental Health Plans, by Ben Roberts

2020 Presidential Candidates’ Mental Health Plans

2020 Presidential Election Candidates' Mental Health Plans, by Ben Roberts

As we approach the 2020 presidential election, there are hot debates about a number of topics. From immigration to health care and gun control to the economy and taxes, there are plenty of problems to be solved. Another topic that is not discussed or debated as much is the growing mental health issues we are facing as a country. Suicide rates and opioid addictions are some of the leading causes of death in the United States. One in five people reports having struggled with mental wellness. With these staggering statistics, it is no wonder that some of our 2020 presidential candidates are speaking out about these issues.

An American flag waving on a flagpole in front of a mountain landscape

Let’s Take a Look at the Candidates’ Plans

Of the current front runners (as of March 24th, 2020), nearly all of them at least mention mental health issues as part of their platform. Our hope is that after reading this, you can feel more informed on where our future president stands regarding mental health.

Joe Biden:

(https://joebiden.com/healthcare/)

In his past government work, Joe helped implement the mental health parity law and worked to eliminate the stigma around mental health. His campaign website states that he will redouble those efforts to ensure the enforcement of mental health parity laws and expand funding for mental health services. Mental health parity laws address the equal treatment of mental health conditions in health insurance plans and help allow people to receive the treatment they need. Joe also participated in an interview about mental health where he goes more into detail on veteran mental health, drug abuse, and opioid addiction, mental health for underserved populations, and more. You can find that here: https://www.mentalhealthforus.net/candidate/joe-biden/

Bernie Sanders:

(https://berniesanders.com/issues/medicare-for-all/)

If we look at the candidates still in the race, Bernie Sanders is probably the most vocal about the need for mental health resources and healthcare overall. Bernie states that we should be spending more money on mental health specialists and investing in new drugs and technologies that help cure diseases and alleviate pain. His Medicare for all plan includes ways to shift money away from big pharmaceutical companies and health insurance lobbies and towards the American people. This would help provide mental health care for Americans that need it at either a low cost or no cost at all. His plan includes increasing taxes on the wealthy and on corporations in order to pay for this.

President Donald Trump:

(https://www.donaldjtrump.com/about/)

On Trump’s campaign website, there is no mention of mental health. He does discuss the opioid epidemic and that the administration has helped forward $500 million from our national budget towards treating opioid abuse. Despite there not being much on Trump’s campaign website, he has shown that he is committed to helping people struggle with their mental wellness. In December 2019, President Trump announced an increase in mental health spending, which would go on to help the opioid crisis, veterans, and early mental health problems detection. President Trump has mentioned he recognizes the long-term benefits of addressing mental health with strategies and programs that have shown positive outcomes.

The Impact of a Candidate’s Mental Health Plan

After looking at the data, there is no question that our nation, and even the world, is having trouble combatting the mental health problems we face today. It is my belief that the private sector, the government, and we as friends, family, neighbors, and strangers need to come together and help combat the problems we face today. It is possible that a certain candidate’s mental health policy won’t sway your vote one way or the other, but it is a factor to consider, and one that may become more important in the future.

Whatever political stance you may take, we invite you to investigate further into your candidate’s mental health plan. See if it lines up with your belief and if they are working to address the mental health problems our nation is facing. And if you’re up for it, share your mental health journey with us at overtfoundation.org/share.

If you’re interested in seeing some of the past candidates’ ideas, see below:

Elizabeth Warren:

(https://elizabethwarren.com/plans/health-care)

Warren mentions that we must “prioritize affordable, high-quality mental health services.” She introduces her “Behavioral Health Coverage Transparency Act”, which would holder insurers accountable for providing mental health benefits and ensure that Americans receive the protections they are guaranteed by law. She also mentions investing $100 billion dollars over the next 10 years in fighting the opioid crisis, which would go towards the people on the front line: first responders, public health departments, and communities on the front line.

Andrew Yang:

(https://www.yang2020.com/policies/mental-health/)

Andrew Yang has specific ideas around the opioid epidemic as well as investing in mental health. He mentions specific ideas such as mandatory postpartum depression screening, increasing resources for social workers in rural areas, and encouraging major health care systems to integrate mental health professionals into their primary care. Yang is also big on technology and discusses ways we can integrate new and emerging technologies into our future mental health treatments.

Pete Buttigieg:

(https://peteforamerica.com/issues/#MentalHealth)

Pete’s website includes a specific section on mental health and combatting addiction. He hopes to prevent 1 million deaths due to drugs, alcohol, and suicide by 2028. Buttigieg will also empower communities to leverage their own innovation and expertise to improve mental health and prevent addiction through a 10-year $100 billion Healing and belonging grant program. He hopes to decriminalize mental illnesses, require schools to teach mental health first aid courses, and help ensure that mental health care is as accessible as treatment for physical conditions.

Mike Bloomberg:

(https://www.mikebloomberg.com/getting-it-done)

On Bloomberg’s campaign website, there was no mention of mental health in his health coverage policy section. He does have a separate section about the opioid epidemic, where he states that he hopes to help hospitals be better equipped to fight these issues and enforce current laws surrounding mental health treatment and substance abuse disorders.


Ben Roberts, Director of Community 

Ben enjoys helping people become their best selves and enjoys working to help solve problems around mental health to ensure that people can live fulfilling lives. He joined the Overt Foundation in April of 2019 and works to help ensure that things run smoothly and that people are getting the help they need.


If you or anyone you know is facing mental health challenges and needs support, we can help you.

You can share how you’re feeling or about your experience, or apply to our subsidized therapy program.