Understanding Health Insurance | NAMI

Health insurance can seem like a real mystery. There are different types of plans and many ways to receive insurance. Additionally, plans are regulated in different ways, including: public insurance plans, which are run by the federal government, and private insurance plans that are mostly regulated by states.

Different Types Of Plans

Public insurance plans include Medicare, which mostly covers senior citizens and people with disabilities severe enough that they cannot work, and Medicaid, which is available to low-income individuals and families. These plans cover most hospital-based care, and many private clinicians also accept Medicare. In some cases, people covered by Medicare and Medicaid are required to receive treatment in hospital-based or public clinics. The law does not require private providers to accept public insurance, such as Medicaid and Medicare.

Private insurance plans vary in the coverage they provide, and this can complicate mental health treatment. While federal law requires that insurers provide comparable coverage for both mental health care and physical health care (this is called “parity”), many plans don’t cover certain mental health services. It’s important to understand the difference in your company’s coverage of mental health services and general health services. It’s also important to keep in mind which plans cover mental health services “in network,” versus “out of network” because that will have a large impact on the overall cost.

If you are looking for a new insurance plan, you might need to speak with someone who has experience in this area to help you understand what a policy covers. You can ask a parent or other trusted adult if they have knowledge in this area, or you can call your insurance company directly to have someone help you understand your coverage.

Making The Decision To Stay On Your Parent’s Plan

You may be able to maintain insurance coverage through a parent’s plan as a young adult. The federal government requires all work-based insurance plans to offer the option of coverage for dependents up until age 26. So, if you have a parent that has insurance through their job, they should be able to keep you on their coverage plan until you reach the age of 26.

There are two things to consider in making the decision to leave your parents’ coverage:

  1. Being on a parent’s insurance might not be the most affordable option if you are in school or employed. If your school or work provides the option for you to receive coverage, try to compare costs, as individual coverage is often cheaper than family coverage.
  2. If you are covered by a parent’s plan, the insurance company may send a report called an Explanation of Benefits (EOB) when you receive treatment services. While the report might be mailed with your name on it, it could go to your parent’s home address. If you have serious concerns about privacy regarding your physical or mental health care, this potential disclosure could present a challenge.

Some insurance plans allow beneficiaries to extend coverage to long-term partners as well as dependents. If you are in a long-term relationship, joining your partner’s plan may also be an option.

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text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).