In recent years, there has been a growing recognition of the importance of mental health and behavioral well-being. As a result, more individuals are seeking assistance for a wide range of behavioral health issues, including anxiety, depression, substance abuse and other disorders.

However, accessing the necessary treatment and therapy can be a significant financial burden for many people if insurance companies do not assist with covering treatment costs. Do insurance companies cover behavioral health? In this blog, we’ll answer this and other behavioral health insurance coverage questions.

Behavioral health coverage refers to the extent to which health insurance plans provide benefits for mental health and substance abuse treatment. Historically, mental health services were often overlooked or underrepresented in insurance plans compared to physical health services.

However, legislation such as the Mental Health Parity and Addiction Equity Act (MHPAEA) in the United States has aimed to address this disparity by requiring insurance plans to offer comparable coverage for mental health and substance abuse treatment.

In this section, we will explore the types of insurance coverage for behavioral health and what they mean.

This includes individual therapy sessions with psychiatrists, psychologists, counselors and social workers, as well as group therapy sessions or Intensive Outpatient Programs. Outpatient services are almost always at least partially covered by insurance plans. The extent of coverage may vary based on factors such as the type of therapy and the provider’s credentials.

In cases where intensive treatment is necessary, such as hospitalization for severe mental health episodes or detoxification for substance abuse, inpatient services may be required. Many insurance plans provide coverage for inpatient treatment, but there may be limitations on the duration of stay and the facilities covered. While most insurances cover acute mental health stays for things like suicidal ideation, self-harm and addiction, only certain insurances cover long-term treatment programs for behavioral health services.

In most cases, insurance companies will cover medical detoxification from substances. Residential rehabilitation, or long-term stays for addiction recovery, are sometimes covered by insurance, depending on the plan.

Prescription medications are often an essential component of behavioral health treatment. Many insurance plans cover psychiatric medications, although there may be differences in copayments or formulary restrictions.

With the increasing popularity of telehealth services, many insurance plans now offer coverage for online therapy sessions. This can be particularly beneficial for individuals who may have difficulty accessing traditional in-person therapy due to logistical or geographical barriers.

In this section, we will take a look at some of the factors that may affect insurance coverage for behavioral health services.

The type of insurance plan you have can significantly impact your behavioral health coverage. Employer-sponsored health plans, individual market plans, Medicaid and Medicare may have different coverage levels and requirements.

Insurance plans often have networks of preferred providers, and seeing an in-network provider typically results in lower out-of-pocket costs for the insured individual. It’s essential to check whether your preferred therapist or treatment facility is in-network with your insurance plan.

Like other medical services, behavioral health treatment may be subject to deductibles and copayments. These are the amounts that you are responsible for paying out of pocket before your insurance coverage kicks in. Understanding your plan’s deductible and copayment requirements is crucial for budgeting for treatment costs.

Some insurance plans require prior authorization for certain behavioral health services, particularly for inpatient treatment or specialized therapies. This means that your healthcare provider must obtain approval from the insurance company before providing the service, which can impact the timeliness of care.

For example, in our Strong Hope Military Trauma Recovery Program, active-duty service members get treatment for PTSD, and the mental health clinic at their duty station must submit a referral of our program to the insurance company for prior authorization. This way, the insurance company will cover 30-day inpatient hospitalization for trauma for the veteran.

Access to affordable behavioral health care is essential for promoting overall well-being and addressing mental health challenges. While insurance coverage for behavioral health services has improved in recent years, navigating the complexities of insurance plans can still be daunting. By understanding your coverage options, advocating for your needs, and exploring alternative resources, you can take proactive steps towards accessing the care and support you need for your behavioral health journey.

Salt Lake Behavioral Health accepts many insurances for behavioral health care such as inpatient psychiatric care, crisis stabilization, medical detox, PTSD treatment, addiction rehabilitation, and intensive outpatient services. Call 801-264-6000 to speak with admissions staff about whether our hospital accepts your insurance plan.

Salt Lake Behavioral Health is a private freestanding psychiatric hospital that specializes in mental health and substance abuse treatment. Our services are provided to adults 18 years and older. Located in Salt Lake City, Utah, we also service the surrounding areas.

Here at our facility we offer a comfortable and confidential atmosphere. We pride ourselves on having specialty behavioral programs that are tailored to meet the needs of each individual. Some of our program include our addiction, inpatient and outpatient services.

To schedule a no cost 24/7 assessment, give us a call at (801)264-6000.