Does Health Insurance Cover a Psychiatrist?
Your health insurance may cover treatment from a psychiatrist under the mental health portion of your policy. Sometimes called behavioral health, this section of your policy typically outlines what type of coverage you’re allowed and what type of mental health professional you can visit.
Each health insurance policy differs. Your policy will also come with a host of stipulations you must follow to be eligible for whatever coverage it offers.
What stipulations might a policy have?
Health insurance policies may have any number of stipulations related to mental healthcare coverage, according to the American Academy of Adolescent and Child Psychiatry. In addition to outlining what type of mental healthcare provider visits are covered, the policy may limit the number of visits per year.
It may also include an annual limit, which dictates the total amount of coverage per year, or even a lifetime limit, which outlines the total amount of coverage over the entire life of the policy. You may need to reach your annual deductible before your mental health coverage kicks in.
Your mental health coverage may also have restrictions on what portion of the treatment is covered. Costs incurred beyond office visits may include inpatient care, medications, or even hospital stays in severe cases. If you do need hospitalization, your plan may again have a network you must stay within to receive coverage for your stay.
The policy may require you to visit a psychiatrist that is part of the insurance company’s network, and that network may or may not include providers that offer the specific care you may be seeking. You may have the option of going outside the network, but you will most likely have to pay a bulk of the fee out-of-pocket if you do.
Your diagnosis is another factor. Not all health insurance plans may cover every single diagnosis. Not all will cover pre-existing diagnoses that were discovered prior to enrolling in a company’s plan.
You may additionally need a referral from your primary care doctor or other healthcare professional to be eligible for psychiatry coverage. You may also have very specific instructions to follow if the initial psychiatrist you visit doesn’t work out and you want to try another.
Plans may only cover treatment from specific mental healthcare professionals. Some may allow visits to a psychiatrist, while others may only cover psychologists or other types of counselors.
What’s the difference between a psychiatrist and psychologist?
The main difference between a psychiatrist and psychologist is the M.D. at the end of the psychiatrist’s title. Psychiatrists have medical degrees and are authorized to issue prescriptions. They undergo a medical residency after medical school, as explained by CNN.
Psychologists generally hold Ph.D.s and their post-graduate internship consist of hands-on clinical work. Their background plays a role in the type of treatment plans they may advise, with the psychiatrist more likely to include medication in the treatment and the psychologist more likely to focus on treatment with psychotherapy.
Severe mental health disorders and conditions, such as bipolar disorder and schizophrenia, are generally referred to a psychiatrist. Anxiety disorders and other less severe mental health issues may be referred to a psychologist.
Where do therapists and counselors fit in?
The term therapist can refer to any mental healthcare provider that is engaging in therapy. This can include a psychiatrist or psychologist, but it can also include social workers and marriage or family counselors, according to AllPsychologySchools.com.
The distinction among the various types of therapists typically comes from their background and education levels. Psychiatrists and psychologists generally have the most advanced degrees, with a medical degree and doctorate, respectively.
Social workers, counselors, life coaches, and other types of therapists may hold one or more graduate degrees, although requirements vary based on certification levels dictated by each state. Most mental health professionals will also have experience in their specific field. This experience can include clinical work or a background working as an assistant under a trained and licensed mental healthcare provider.
How do I know what type of mental healthcare professional to see?
Your primary care doctor may be able to help you decide what type of mental healthcare provider may be most effective in your particular case. Your insurance company may also have a review team that helps discern what type of treatment may be most beneficial based on your symptoms and health history.
You may also be advised to see more than one type of mental healthcare provider. For instance, those who need psychotherapy and medication may regularly visit a psychologist for psychotherapy treatments and supplement their treatment plans with occasional visits to a psychiatrist to obtain a prescription for their medication needs.
Each plan varies, and not all will be flexible enough to cover every treatment plan. Even if your plan does not cover the type of mental health care you need, you may be able to work out a payment schedule with your mental healthcare provider. Some may offer a pay scale based on your income that helps you afford the help you are seeking.