Understanding Health Insurance

Insurance is a crucial tool that can grant access to needed treatment to get well. Health insurance helps pay for mental health care needs including checkups, visits to specialists, emergency care and hospital stays. In most cases insurance will keep a person from paying the full cost of medical services.

Getting insured or reviewing your current insurance plan may seem complicated, but knowing the basics can help you navigate the system successfully. 

Types of Health Insurance

Understanding the differences about health insurance plans can help a person make an informed decision about what plan is appropriate and what options are available. The level of coverage and availability of services and mental health professionals depends on the type of plan chosen.

Common types of health insurance include:

  • Private Health Insurance
  • Medicaid
  • Medicare
  • CHIP
  • TRICARE and VA Health Care

If insurance is provided through a job or government programs, there may be fewer health plans that are available to choose. If insurance is not offered by an employer or you are not enrolled in a government program, additional insurance options are available through the Health Insurance Marketplace.

Read more about these insurance options that may be available on our page about types of health insurance.

How Much Insurance Does Someone Need?

Each person is different and not everyone needs the same amount of insurance. The limiting factor for many people is the cost of the plan. But a person should make sure to get the most coverage for the money he or she spends.

Whether choosing insurance for the first time or evaluating a current plan here are some things to keep in mind.

  • Affordability. Compare monthly premiums, deductibles, co-pays and/or co-insurance to make sure you are getting the best deal for your health insurance needs. Consider not just about how much is paid per month for coverage, but also how much money is needed to pay co-pays and co-insurance. Would a plan with higher premiums have cheaper co-pays or co-insurance?
  • Availability of mental health professionals. Make sure there is a broad range of mental health professionals included in the health plan’s network of providers. Some mental health professionals do not take insurance, so check to see what the insurance plan will pay for out of network providers.
  • Coverage of prescription medications. If a person has found the right medication to treat their illness, she should find a plan that covers that medication to maintain wellness.
  • Limits on the number of mental health-related office visits. Some health plans place limits on the number of office visits for things like therapy. Choose a plan that allows the number of visits needed. Depending on a person's need, he may need to consider differences in inpatient and outpatient coverage.

Ensuring Equal Coverage for Mental Health

Federal law requires mental health conditions and substance use disorders be treated equally to physical illnesses. This is what is known as mental health parity. However, the federal law does not require plans to offer coverage for mental health or substance use disorders. But if these conditions are covered, then the law requires that the level of treatment and services is the same as other health conditions. 

For example, if an insurance plan provides unlimited visits to a doctor for a chronic heart condition it cannot limit the number of visits for a mental illness like depression or bipolar disorder. Find out more about parity and what you can do if your health plan is in violation