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The Transition House, Inc.

3 things you should know about mental health insurance coverage


two people talking - 3 things you should know about mental health insurance coverage

Did you know your health insurance covers mental health treatment? Everything from routine talk-therapy to inpatient residential treatment is covered. This is because mental health services fall under essential health benefits. Here’s what you need to know to make sure you’re taking full advantage of your health insurance plan.

1. What does mental health insurance cover?

Health insurance plans are required to cover mental health services in the same way they cover services for other health conditions. This includes:

If you have health insurance through a major insurance provider, it’s likely that your plan covers these services. There are a few services that might require pre-authorization, and you should check with your plan to see what those services are prior to scheduling an appointment. For example, Aetna requires pre-authorization for residential treatment and partial-hospitalization programs (PHP).

2. How does therapy and insurance work?

Visiting your therapist at a counseling center is just like visiting your general practitioner or family doctor. Typically, your doctor’s or counselor’s office will ask you for the name of your insurance provider, plan name and identification or group number. If you have an insurance card, make sure to have it readily available since it has all of the information they’ll need and will make the process easier.

3. How much does therapy cost with insurance?

Once your therapist’s office has your insurance information, they’ll be able to contact your insurance provider to see what fees, if any, you are responsible for at each appointment. There are three different types of fees depending on your plan:

  • Deductibles are the out-of-pocket fees you pay before your insurance kicks in. For example, if your deductible is $1,000, you are responsible for the first $1,000 of medical fees before your insurance will pay for your visits or treatment. Let’s say each visit to your therapist or doctor is $50. You’ll pay for 20 visits before your insurance begins covering your appointments.
  • Coinsurance means your insurance will pay for a portion of your visit and you will pay for the other portion. Let’s say your insurance covers 75% of your doctor’s visits. If your appointment costs $100, you’ll pay $25.
  • Copays are fixed amounts due at every appointment. If your copay at your family doctor is $20 per visit, it will be $20 to visit your therapist.

Regardless of the type of fee your insurance plan requires you to pay, the cost to visit your therapist for depression or other mental health conditions will cost the same as visiting your family doctor for a cold.

You should always check with your insurance provider to understand your individual health plan. The good news is that if you have health insurance, your mental health care is covered just like any other health condition. Make sure you’re taking full advantage of your insurance plan and making your mental health a priority.

If you're ready to make an appointment, you can find out which insurance providers we accept at each of our locations here.

Request an appointment at TTHI Counseling Center

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