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Facts About Mental Health Insurance

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Facts About Mental Health Insurance

Facts About Mental Health Insurance

It has been found that millions of Americans have some kind of mental disturbances, be it stresses, grief, depression or some serious problems. However, a third of these mental ill people only get proper treatment. The reason for this situation is that these people do not have access to proper mental health insurance or else find it quite embarrassing to look for treatment of their mental disorder. There are different types of mental health insurance plans available that meet the specific needs and budgets of all kinds of mental patients. However, one must know the facts about Mental Health Insurance to get the right plan for them.

Facts About Mental Health Insurance

Normally, patients with mental health insurance get coverage of 20 to 30 sessions every year. Patients are supposed to pay a certain percentage of bill amounts, which is between 20 percent and 50 percent. Medicare on the other hand covers half of outpatient care cost with no limit on the number of visits. Problems covered in the plans depend on the insurance provider. However, most providers provide coverage for such mental issues like anxiety, depression, relationship difficulties and different social phobias. The plans also do not cover IQ tests and screenings done for finding mental disabilities. Depending on the mental health insurance plan chosen, one can see a therapist of their choice. Many insurance providers ask for referral from some primary care physician and hence it is important to ask the provider before looking for some therapist.

Different Types Of Mental Health Insurance Plans

  • Fee-For Service:

    In this plan, you pay a monthly fee as premium and select a doctor of your choice. You get visits to hospital for getting medical services in the plan. The insurance companies pay for the services received. There is a deductible with the plan and one has to spend that amount each year on health care before insurance coverage can begin. The policyholder has to share a certain percentage of the total amount.

  • HMO:

    This plan is similar to prepaid health plans. The holder of the policy has to pay a monthly premium while the HMO covers all the health care expenses. The list of providers and facilities are however limited. A primary care physician is assigned in HMO who provides the referral to some specialist from a group of professionals. The policyholder has to pay a small copayment for each visit.

  • PPO:

    It is a Preferred Provider Organization and is a combination of fee-for-service plan and HMO plan. The holder of the plan gets national coverage and the choice to select from providers which are offered on a preferred list by paying a low cost. There is also the option to pay higher fees out-of-pocket to see the providers who are not on the network.

  • POS:

    This is the Point-of-Service plan and is similar to HMO plan. One can see physicians outside the network. There must be a primary care physician to see for using in-network providers. This plan is a regional plan. Although, members are able to use the services that are outside the area of HMO, they must however have residence within the HMO area to get the coverage.

  • Public Mental Health Service:

    If someone does not have any insurance, they can still be eligible to get coverage for mental health services that are available through governed agency. Government provides mental health care that depends on the place, state, county or city the individual resides. The health service is provided on a sliding scale schedule. The government determines the fee for health care service after consideration of family size and income.

  • Medicare or Medicaid:

    If someone does not have any EAP or some insurance coverage from their employer, they can access the federal mental health services provided under Medicare or Medicaid. The coverage provided differs by state, although there is standardization of programs while the coverage provided depends on system of reimbursement given to providers.


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