If your health insurance policy is not a grandfathered plan put in place before the Affordable Care Act (ACA) provisions went into effect and certainly if you have enrolled in a major medical policy after January 1, 2014 then the answer is "Yes". Under the ACA law health insurance plans must treat mental health and substance abuse problems as any other illness. In addition, there are now provisions for preventive care services in relation to some mental illnesses, depression screening and behavioral assessments for example, that must be covered at no cost to the member.
A policy holder should carefully examine the provisions of their own policy or call their insurance carrier's member services department to verify what services are covered, where they are covered and what coverage provisions of your contract your needed services are subject to. For example, if you are an individual who enrolled in a Bronze level plan and you need mental health services that are not preventive in nature but are for actual treatment then it is a virtual certainty that these services will be subject to your plan's deductible and/or co-insurance provisions before you begin to see the insurance carrier paying for these services. In many cases this could be an amount in excess of $6000 before you would cease paying out-of-pocket for any services. Also, verify which mental health/behavioral health providers and facilities are in-network with your provider and determine if you have to be pre-certified to see any of these providers before you seek care in a non-emergency situation.
Great question! One of the great things about the Affordable Care Act ( Obamacare), like it or hate it, is that it increased coverage for issues that weren't covered before. One of these is mental health care. If you have a policy purchased through the exchange, or after the beginning of this year, then there are certain services that are free, and others that have the usual deductible and co-pay requirements. Take a look at your individual policy, or contact the service provider to know for certain what you will be obligated to pay for. Thanks for asking!
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Mental health is covered by most health insurance policies, but NOT all of them. I'll explain:
As a health insurance broker that has more than 33 years of experience (The time went fast!), this topic is often discussed. Any newly-issued Marketplace (Obamacare) policy must contain specific mental health benefits. It is one of the 10 "essential" benefits that legislation mandated to be covered.
Many "grandfathered" plans do not cover these types of benefits, which is perfectly legal. And of course, you may have these types of benefits, but a deductible and/or coinsurance may apply.
However, "short-term" plans (that are not ACA-compliant) are very popular, especially for persons that missed Open Enrollment or simply want no part of the Affordable Care Act. Typically, they do not cover mental illness expenses.
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A policy holder should carefully examine the provisions of their own policy or call their insurance carrier's member services department to verify what services are covered, where they are covered and what coverage provisions of your contract your needed services are subject to. For example, if you are an individual who enrolled in a Bronze level plan and you need mental health services that are not preventive in nature but are for actual treatment then it is a virtual certainty that these services will be subject to your plan's deductible and/or co-insurance provisions before you begin to see the insurance carrier paying for these services. In many cases this could be an amount in excess of $6000 before you would cease paying out-of-pocket for any services. Also, verify which mental health/behavioral health providers and facilities are in-network with your provider and determine if you have to be pre-certified to see any of these providers before you seek care in a non-emergency situation.
As a health insurance broker that has more than 33 years of experience (The time went fast!), this topic is often discussed. Any newly-issued Marketplace (Obamacare) policy must contain specific mental health benefits. It is one of the 10 "essential" benefits that legislation mandated to be covered.
Many "grandfathered" plans do not cover these types of benefits, which is perfectly legal. And of course, you may have these types of benefits, but a deductible and/or coinsurance may apply.
However, "short-term" plans (that are not ACA-compliant) are very popular, especially for persons that missed Open Enrollment or simply want no part of the Affordable Care Act. Typically, they do not cover mental illness expenses.