There is a stigma in the United States against those who suffer from mental health issues. It can be discriminating and prejudicial as many people believe that individuals suffering from mental health issues to be dangerous and difficult to talk to.
The reality is that mental health illness is much more common that we believe it to be. However because of these stigmas, it’s not as widely discussed as things like cancer or diabetes.
In the U.S. approximately 1 in 5 adults or about 44 million people experience mental illness in a given year. Sixteen million Americans have experienced at least one major episode of depression the past year. In fact, ten million Americans have a serious mental illness that can interfere with their everyday life. Mental illness is a part of life and needs treatment like any physical illness.
MHPAEA and ACA
Americans in need of mental health care got a big boost from two laws. The first is the Mental Health Parity and Addiction Equity Act (MHPAEA). This is a federal law that prevents group health plans and insurance companies that offer mental health or substance abuse disorders benefits from imposing unfavorable benefit limitations, like annual or lifetime dollar limits on the benefits, compared to limits on medical benefits.
In 2010 MHPAEA was amended by the Affordable Care Act (ACA) to include individual health insurance plans. It also changed the definition of what a small employer to companies with 1-50 employees. This is important because MHPAEA does not apply to small group health plans, just large group health plans.
The Affordable Care Act requires all marketplace plans (state or federal) to cover mental health services. These services can include:
- Behavioral and cognitive therapy.
- Substance abuse treatment.
- Inpatient care at a full-service mental facility.
Employer plans don’t have this requirement, but a survey from the Society for Human Resource Management discovered 91 percent of employer plans covered mental health.
Mental Health Coverage
As with your physical ailments, each health insurance plan offers different coverage. It’s important that you look at your coverage to understand what benefits are offered. If you have questions about your coverage, you can refer to your summary of benefits, which is required by law. Or if you are looking for a plan, speaking with a health insurance agent can help guide you to finding the most suitable plan. All other questions can be answered by contacting your health insurance provider directly.
If you are covered by Medicaid or Medicare, there are mental health options available. Medicaid offers some services like counseling, therapy, and substance use disorder treatment. Medicare has a wide range of services for those in need of mental health services. These are covered by Part A, B, and D. Part A is for inpatient stays at a hospital while Part B covers doctor visits like to a psychiatrist. Part D covers any drugs that may be prescribed for your mental health.
Mental health illness isn’t something we should be ashamed of or shy away from. It’s a medical need just like a sprained ankle. It must be addressed or it will get worse. The good news is that today’s medical environment is more open to helping treat mental illness than in decades past. Check with your health insurance provider to determine the exact coverage you have.