Mental Health & Insurance: Where Are We Now?

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Mental health is an essential aspect of healthcare. An estimated 56% of Americans seek such care for themselves or loved ones. Yet, medical insurance does not always cover mental health treatment. 

As awareness of the importance of accessible mental health care grows, insurance provisions are increasingly covering this dimension of health. However, there is still a long way to go. The Affordable Care Act as well as Medicare and Medicaid have attempted to make mental health care more accessible to millions of vulnerable Americans, but high costs still serve as a barrier to care. 

Understanding where we are with mental health and insurance is an important step in knowing how far we need to go to ensure comprehensive care coverage. Here, we detail how federal programs have expanded access to mental health care and give tips for those looking for mental health on a budget.

The Affordable Care Act 

Before the passage of the Affordable Care Act — also known as Obamacare — 15% of Americans went without health insurance. Afterward, this number dropped to 9%. Suddenly, many without care were able to get into the market, meaning mental health treatment without severe economic consequences was possible. 

Another key component of the ACA was that it mandated that individual and small-group coverage included access to mental health and prescription drugs. Within these provisions was the requirement that insurance providers cover preventative mental health screenings for all plans. As a result, awareness of and access to mental health treatment are on the rise. 

The ACA has created expanded health coverage leading to better health outcomes for millions of Americans. These outcomes include:

  • Reductions in poor mental health
  • Reduced severe psychological stress
  • Relative self-reported health improvements
  • Reduced out of pocket spending

With provisions of the ACA expanding Medicaid in states that accepted it as well as coverage for individuals up to age 26 through their parent’s plans, more Americans than ever have been able to seek out mental health. This improves healthcare solutions while reducing costs for vulnerable low-income individuals. 

In including mental health in insurance coverage, the ACA has been a massive step forward. Without Medicare and Medicaid programs, however, the ACA would not have been as effective.

Medicare and Medicaid

Medicare and Medicaid are the oft-confused governmental programs that provide health coverage for millions. They are separate in their coverage levels and area of focus. Medicare, for example, was created to protect coverage for older Americans along with some individuals with disabilities. In contrast, Medicaid was meant to bridge the affordability gap for those unable to afford traditional insurance or who cannot receive it from their employers.

Medicare Part B covers mental illness diagnosis and treatment. Alongside supplementary plans like Medicare Part C, it can cover even prescription drug costs with only marginal expenses for the insured. Depending on the insured’s city and state, co-pays and deductibles can vary.

Medicaid plans cover various aspects of mental health care for eligible individuals. States were able to expand Medicaid to cover an increased portion of the affordability gap. However, not all states voted to do so. Once again, depending on the insured’s place of residence, coverage eligibility may vary. 

For those with Medicaid, covered mental health services include:

  • Inpatient care
  • Outpatient services
  • Psychiatric treatment
  • Counseling
  • Prescription medications

The availability of mental health services possible through these federal insurance programs have enabled care options for many low-income Americans. However, many still struggle with health care costs and seeking mental health treatment coverage on a budget.

For those that find themselves unable to afford mental health treatment and are ineligible for the above programs, we’ve assembled a list of options for you. 

Mental Health on a Budget

Mental health can be costly. Without a comprehensive insurance plan that covers all aspects of mental health care, you might be looking at life-disrupting medical costs. Medical debt is one of the most significant causes of bankruptcy in America, an event requiring extensive credit repair and financial maneuvering to recover from.

The state of mental care coverage requirements is better than it has been in America due to provisions from the Affordable Care Act and expansions to Medicare and Medicaid. However, finding insurance that covers mental health treatment can still be difficult if one falls into a coverage gap. 

Luckily, there are some affordable options out there for seeking mental health without insurance. If you or a loved one needs treatment, consider the following therapy options for every budget:

  • Sliding-scale therapists — Many mental health professionals are willing to negotiate fees on a sliding scale based on income. Seek these out to find an option within your budget. 
  • Free and low-income clinics — Nonprofits that provide care free of charge or on a sliding scale to lower-income individuals are available in some cities. The difficulty, however, is that these often come with significant waiting times. 
  • Therapy applications — With the boost in mobile technology, mobile apps that give you access to a therapist are available. These can be lower cost than traditional therapy models and could be worth looking into. 
  • Support groups — Almost every community offers support groups to assist those in need without a cost involved. Seek out these resources in your own communities to find further help. 

For more immediate care, depression rehab centers often take insurance or can work out payment plans for those in need of care. Both inpatient and outpatient options exist.

If you or a loved one are experiencing at-risk mental health symptoms like suicidal ideation, extreme mood swings, cognitive impairment, or aggressive and violent behavior, a voluntary mental health admission can be the right step towards stabilizing mental health and accessing invaluable resources that can work for you no matter your income bracket. 

While medical costs can be concerning, they should never be a reason to prevent care. Medical facilities can negotiate costs to assist you in care options, ensuring you find the solutions you need. For less immediate care needs, low-cost options should be explored to help you find the right fit for your health and budget. 

Suicide Prevention

If you or a loved one are experiencing a mental health emergency, try the National Suicide Prevention Lifeline at 800-273-8255. Stay with the individual until professional help is available. 

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