You Deserve The Right Coverage
When I worked at a psychiatric hospital, it was commonly known people would not receive adequate coverage when it came to mental health treatment. One phone call after another, I questioned how anyone would expect for someone to get better mentally, with high deductibles or out of pocket expenses. This left families dumbfounded and unsure if they can managed their daily living expenses or dip into their 401k to help their loved one with their treatment.
It often disturbed me and it became common for me to get upset or not even want to entertain calling the insurance companies to discuss coverage for someone who needed to step into another level of care. Mental Health & Parity Act provides equal coverage insurance companies have to provide. Therefore the same kind of coverage you receive for somatic issues, ex. diabetes or physical challenges, by law you should receive when dealing with mental health issues, whether its seeing a psychiatrist, therapist, or other mental health treatment.
Let Me Break This Down…
Co Pays & Deductibles
A charge for mental health care can not be more than medical care. If you see a cardiologist at $30 copay, you should have the same co pay to see a therapist or mental health specialist.
Doctor Visit Limits
There is not limit on medical visits, therefore there is no limit on therapy visits.
Prior Authorization Rules
Insurance cannot make it harder to get approve for mental health treatment versus medical treatment. If there is no pre-authorization for outpatient surgery, there will be no pre-authorization for a therapy session.
Inpatient Treatment
Insurance companies cannot have unlimited hospital stays for pneumonia but only 7 days for inpatient mental health treatment. That would violates parity.
Out-Of-Network Coverage
If your insurance plan covers out of network surgeons it must cover out of network coverage for psychiatrist and mental health treatment centers.
The Parity law aims to reduce discrimination in insurance coverage. There are network shortages that can make it harder to find providers, but I always encourage people to ask for help. If a doctor is recommending a provider, ask for a list. Reach out to your insurance company and ask them to provide you with an updated list. Be sure to involve your support system, they too can look for providers and ask around. Do not be afraid to advocate for yourself, many people are willing to help when it comes to finding support. Dial 988 for resources and know that you do not have to deal with this alone.