Does Health Insurance Fail Mental Health & Substance Abuse Needs?
The Californer/10239972

NEWPORT BEACH, Calif. - Californer -- According to the National Institute of Mental Health about 21 million adults in the United States had at least one major depressive episode in 2020 [1]. Over 40 million adults in the U.S. have anxiety disorder [2]. In 2021, 61.8 million Americans used illicit drugs and 94% of those with substance abuse disorder did not receive treatment [3]. May is Mental Health Awareness month, a good time to evaluate whether or not you need help with mental health or substance abuse. It's also a good time to review your current health insurance policy to see if the services you require are covered.

Health Insurance Covers Mental Health and Substance Abuse – But Not Always

If a health insurance plan is part of a state- or federally-managed marketplace — like Healthcare.gov or Covered California — it must cover mental health services, including substance abuse and behavioral health treatment. If you have a good individual private plan and you go out-of-network, your insurance company may reimburse you as much as 80% of each session fee, depending on the therapist's rate. If you have a policy with limited coverage and a high deductible, you may be paying for most, if not all, your therapy sessions as well as physical health providers.

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Under the law, if a private insurance plan provides coverage for mental health and substance use services, the plan's coverage must be equal to physical health services.

For example, benefits must have equal treatment limits, such as:

• Number of days you can stay in the hospital
• How often you get treatment

However, a high deductible plan will be limited for both physical health and mental health..

Keep in mind that if a private insurance plan provides coverage for mental health and substance use services, the plan's coverage must be equal to physical health services.

Other topics covered in this article:

Health Insurance Covers Mental Health and Substance Abuse – But Not Always
Post-COVID Surge in Mental Health Issues
What Happens If I Go Out of Network for Mental Health Treatment?
For What Types of Disorders Is Therapy Covered by Insurance?
If the ACA Says Mental Health Is Covered, Why Am I Not Getting a Full Refund?
High Deductible Plans and Therapy

For the full article, visit https://smartfinancial.com/what-health-insurance-doesnt-cover