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Insurance Needs to Fully Cover Mental Health Treatment

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Insurance companies are notorious for refusing to fully cover health treatments and procedures, but especially so when it comes to mental health. Mental illness carries a heavy stigma, and sometimes that stigma seems to seep into insurance coverage decisions, despite the fact many people who seek mental health treatment are in serious need of their therapies and treatment programs.

When insurance companies cover mental health services, they are capable of covering them well, but far too often, clients need to cut therapy sessions or leave treatment programs before they’re ready because the cost is prohibitive — even with insurance. Therapy often requires out-of-pocket pay, and even when it doesn’t, it may be too costly to be a sustainable option for clients to regularly attend, which could leave them without as much support as they may need. More extensive mental health treatment programs at inpatient, residential, partial hospitalization (PHP) or intensive outpatient (IOP) levels of care can be a “shot in the dark” when it comes to coverage — clients may get covered for months, or they may lose coverage after a few days. The insurance coverage game is unpredictable — and the entire system needs a drastic overhaul.

As someone who is fortunate enough to be able to attend therapy and has also been through several mental health programs at higher levels of care, I’ve seen — and personally experienced — how a lack of insurance coverage can affect clients with mental illness. I’ve seen clients “stepped down” to lower levels of care before they feel ready, not because their team feels they’re ready for a lower level of care, but instead because insurance will no longer cover them. I’ve heard of numerous clients and their families who are forced to pay astronomical sums out-of-pocket because no mental health programs will accept their insurance plans or because they need to stay longer than their insurance will fully cover them.

I myself have been stepped down to low levels of care when I was deep in an eating disorder, and once, I almost didn’t have the opportunity to attend treatment at all because my insurance rejected coverage on the grounds I’d never been to eating disorder treatment before — despite my anorexia nervosa diagnosis. And sadly, outpatient treatment is no easier to pay for, even with insurance. Even in-network rates have prompted me and many others to forgo appointments with psychiatrists and other mental health professionals for months on end.

Our healthcare system is far from perfect, and the inconsistent way insurance covers mental health treatment illuminates just how much it needs to change. Insurance plans should fully cover mental health treatment at every level of care because the financial stresses of constantly forking over large sums of money for treatment can worsen clients’ already-fragile mental health.  To complicate matters, many people who rely on more extensive mental health treatment receive Social Security disability payments, which require adhering to certain “earnings caps” that drastically limit the amount of money people who receive payments can earn. The lack of earnings possibilities for many people combined with the mental health effects of coping with the insurance system itself signify the system needs to change.

People with mental illness who attend appointments with professionals or check into treatment programs often are unable to receive full insurance coverage for their mental health needs, which can drastically limit the quality of the care they receive. Insurance companies need to pay attention to clients’ needs and prioritize their mental health over corporate finances. Only when insurance fully covers mental health treatment can clients with mental illness fully work toward recovery and healing.

Getty image by Fokusiert

Originally published: September 23, 2021
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