Using Insurance for Mental Health Care

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Last Updated on May 11, 2021 by Content

Getting help for mental health care can be tough for some people, especially without insurance. Of the 57.7 million people who suffer from mental health disorders or addiction, only 26 percent receive the vital care they need. Fortunately, federal policies are making mental health services more accessible to Americans.

Mental health disorders or mental illnesses are explained as mind conditions resulting in changes in thoughts, emotions, and behavior. These conditions or ailments are mostly chronic (long-lasting) but maybe occasional (in some cases). The changes made by a mental health problem in a person’s thoughts and behavior will affect his/her ability to function properly and cope with daily life problems.

Mental health disorders are categorized into several types, and their prevalence varies in different areas depending on several factors. Some common mental health diseases are as below;

  1. Anxiety disorders 
  2. Panic disorder 
  3. Phobias 
  4. Depression 
  5. Bipolar disorder 
  6. Personality disorders 
  7. Post-traumatic stress disorder (PTSD)
  8. Schizophrenia

Causes of Mental Health Disorders

Many factors contribute to mental health issues. These factors may be one or more from the following list;

  • Genetics – if one or both of the parents of a person have shown some mental health diseases, it’s a significant risk of developing the same in life span.
  • Family Environment – child abuse is an essential reason in developing such disorders at early ages
  • Nutrition – what we feed a child will express in terms of growth, either physical or mental.
  • Stress – studies, workload, and competition may lead to anxiety and depression.
  • Brain injury
  • Mother’s exposure to addictive drugs during pregnancy
  • Some severe physical health problems – they cause stress and results may be some mental health disorder
  • Isolation from the society

Diagnosis of Mental Health Disorders

Several methods diagnose mental health diseases, but all of them include three basic steps.

  1.  Genetic and medical history of the patient
  2.  Physical exam of the patient (including recommended lab tests).
  3.  Psychological evaluation – mostly carried out via questionnaires designed by expert psychologists.

Treatments Options for Mental Health Care

  1. Psychotherapy Qualified and trained mental health professionals use the therapeutic method of treatment to improve thoughts, emotions, and behaviors for the well-being of affected individuals. Psychotherapy may also be combined with medication for better and speedy results. 
  2. Medication The primary aim of medications is to cope with physical health symptoms related to mental health disorders. Medications should be combined with psychotherapy to promote the recovery process effectively.
  3. Hospitalization also helps individuals suffering from severe mental health issues. It ensures accurate diagnosis and close monitoring of patients. It is more helpful when a person feels worse condition for a shorter period. 
  4. Support Group A support group guides patients and their families through meetings. 
  5. Self Help Programs The physicians treat a patient so that they can address their condition for his wellness. 
  6. Peer SupportPeer support is also an advantageous method of treatment. It refers to receiving help from cured persons by exploring their past experiences.

After the complete diagnosis of the prevailing problem, qualified physicians decide which treatment program or set of programs is suitable for a specific person. It depends on the prevalent mental health disorder, its severity, and other issues present simultaneously.

Areas of Concern For Mental Health Care

Mental health illnesses have become more common in recent years throughout the globe. A very rapid increase was shown in a report (published in 2019) in the United States of America (National Institute of Mental Health). It was elaborated in the fact sheets by the National Institute of Mental Health that about 20% (one in five persons) of the US population faces mental health disorders at least once in their life. According to the census, it is about 51.5 million people in the United States.

The number of patients is increasing so terribly. Still, it is also a sad reality that people often do not think mental health diseases worth attention to as physical health diseases. It is also observed that many people ignore their problems and try to live with mental health disorders. They hesitate to show the conditions and take it as a stigma. People often think these diseases “costly,” so they hesitate to meet a physician and starting a treatment plan according to their mental conditions. 

Although laws are now present and implemented about mental health disorders, it is a sad reality that out of 57.7 people suffering from any mental health disorder, only 26% have received necessary treatment and moved to complete recovery. Recent amendments in federal laws made it relatively easier to obtain mental health care facilities for the United States of America citizens. 

Background on Mental Health Care in America

Mental Health Care Parity Act

This act was presented and implemented in 2008. Mental Health Parity Act restricts the insurers to treat both physical health diseases and mental health disorders. A person suffering from mental health disorder or substance use can get all the required facilities and treatments in case of physical health issues. Before this act, it was not easy to get insurance benefits for a mentally ill person, resulting in increased mental health cases in recent years. This act ensures that mental health problems will be taken as necessary as physical health problems.

Insurance companies, before this act, were not providing mental health care under their group insurance plans. The insurers give logic that the New England Journal of Medicine explained mental health disorders and drug/alcohol abuse  treatment separate from other medical treatments. As a result, assessment to required treatment facilities was restricted, which means patients and their families had to pay for complete treatment until recovery.

The Mental Health Parity Act (2008) was implemented in 2010. This act made it easier for the United States of America citizens to avail themselves of the mental health facilities under group health insurance plans. These group insurance plans now cannot restrict the benefits, leading to complete availability of treatment to mentally ill people. It means that if an insurance plan offers medical health facilities to a person, they can avail that for the treatment of mental health disorders.

The Obama administration implemented that all the people bearing insurance policy from 2014 will be provided “necessary health facilities” by all the insurance companies in  New York Times . “Necessary health facilities” included ten categories of medical care like maternity, mental disorders, and hospitalization. This policy was entitled as President Obama’s national health care plan and covered mental health care issues concisely.

These new laws made mental health care facilities more easily accessible to maximum citizens of the United States of America. Approximately 32 million citizens of the United States have insured for medical facilities. According to the above legal amendments in insurance laws, all of these 32 million people got direct approach to mental health facilities as they have for treatment of physical health problems. The medical insurance plans are not so perfect, as coverage may vary in different states, but it still increased chances of treatment much better than in the past.

Using Your Insurance for Mental Health Care

A person bearing insurance must have the basic knowledge of that particular insurance policy’s terms and conditions to get better care. What type of treatment facility can you avail of, depends on the following points;

  • Nature of the policy

Read your policy terms and conditions properly and listen to the insurance policy representative to know the complete coverage areas of your policy. It is essential to know what exactly will be covered and what will not.

  • Referrals and networks

Check if your insurance company requires referrals for some specific health care facilities. Look at your social circle to check other available options.

  • Cost 

Check the cost of different policies before you decide to take one. Learn about the financial limitations that can affect your specified treatment plan. Also, get information on the treatment centers covered by an insurance provider.

  • Diagnosis

Be sure that you are choosing the right insurance plan to meet your requirements. Some insurance plans place limitations to their coverage over pre-existing health issues.

Information for the Uninsured Mental Health Care

A report based on the National Health Interview Survey showed the following facts;

  • Under the age of 65 years, approximately 45.2 million citizens of the USA do not have any health insurance policy.
  • Approximately 61% of insured people (under-65 group) have private insurance.
  • 20.9% of people were found uninsured in the 18-64 age group.
  • Again 64.1% had private insurance.

People who are still uninsured are directed to contact the federal government via Healthcare.gov to learn about different available plans and their coverage areas. Health care navigators help people find the most suitable insurance plans according to their needs and financial conditions. If a person does not have enough income according to his/her needs, the navigator will help apply for public health insurance under state Medicaid.

Employment-based insurance plans provide alternate sources of health insurance. A person can also benefit through dependent benefits of different insurance plans (i.e., coverage through a family member’s employment-based insurance policy). 

It is advised to all uninsured people to check all the available options and make comparative cost decisions. Contact the insurance company directly and get complete knowledge of all the policies covering your issues.

If you need help with the mental health care treatment plans, call us at Foundation Recovery Network to get complete knowledge of the treatment plan best suited for your mental health issues. We offer you the best services through our qualified and experienced professionals. You can discuss your problems, mental health care treatment plans, and payment methods with them. Our mission is to provide all the required facilities regarding mental health care to you so that you can live a better life.