March 5, 2019
Do you understand your mental health coverage?
An important step in accessing mental health care is understanding the coverage available to you and your family members through your health insurance. Every health insurance plan is different, so it’s important that you know what providers and services are covered, and what your financial responsibilities will be. Carefully read the materials you’ve been provided, ask questions, and BE INFORMED.
The following are questions you can ask:
- Do we have to get a referral from a primary care physician, pediatrician, or employee assistance program to receive mental health services?
- Is there a “preferred list of providers” (doctors or therapists) or “network” that we must see? What happens if we want to see someone outside the network?
- Is there an annual deductible that we pay before the plan pays? What will we actually pay for services?
- What services are paid for by the plan: therapy, office visits, medication visits, respite care, intensive outpatient programs, day hospital, inpatient?
- Are there limits on the number of visits per year?
Here are links to two fact sheets by Mental Health of America-Wisconsin that provide general information and tips about health insurance: