Does Health Insurance Cover Counseling?
Counseling is a broad term that can apply to various types of counseling services, and many health plans will cover one or more of such services. The exact type of counseling coverage your health plan provides should be stated in the policy, whether the counseling relates to physical or mental health issues.
The Health Resources and Services Administration (HRSA) notes that the Affordable Care Act was signed into law in March 2010 and most plans carried the provisions by August 1, 2012. The Act covers a wide range of counseling services that health insurance providers must offer free of charge to policyholders without co-pays, deductibles, or shared costs by other health plan members.
Does the Affordable Care Act Apply to All Health Insurance Plans?
The Affordable Care Act applies to any plan set up on or after the date the Act went into effect. If your health insurance plan was set up prior to the Act, you may have to wait until your policy is updated for the coverage changes to apply. The HRSA warns, however, if your plan is “grandfathered,” or exempt from new laws that go into effect, it may not offer coverage required under the Act.
What Types of Counseling are Covered under the Affordable Care Act?
According to the HRSA, the Affordable Care Act covers many types of counseling that are linked to preventative care. Preventative care is meant to keep you healthy by staving off health-related conditions and diseases or offering screening and tests to regularly check for such conditions so they may be treated at their earliest stages.
The Act says coverage must be provided for counseling related to alcohol misuse, diet counseling for people who are at high risk of developing diseases, and obesity counseling for all adults. Adults who are at a high risk of contracting sexually transmitted infections may also be covered for STI prevention counseling. Tobacco programs that include counseling may also be covered under your health plan as part of the preventative services.
What About Counseling Types Pertaining Specifically to Women?
The Affordable Care Act includes a provision that focuses on women’s health, which requires coverage for counseling types that are specifically related to women’s health issues. Covered counseling in this category includes breast cancer chemoprevention counseling for women who have a high risk of breast cancer, counseling related to breast feeding, and education as well as counseling pertaining to types of contraceptives approved by the FDA.
Covered women’s counseling services also include those related to Human Immunodeficiency Virus, or HIV, for sexually active females and those related to genetic testing for women who are at higher risk for certain cancers and diseases. The Affordable Care Act also requires health insurance plans to provide no-cost counseling for domestic abuse and interpersonal violence.
What About Counseling for Children?
Some counseling services for children also fall under the Affordable Care Act. One is obesity counseling for all children. Another is STI counseling for teens who are sexually active and pose a high risk for sexually transmitted infections.
Do Health Plans Cover Mental Health Counseling?
While the Affordable Care Act focuses on preventative care to improve physical health, your health plan may also cover some type of mental health counseling. Once again, the amount and type of coverage your health plan offers depends on your individual plan. Your mental health provisions are typically outlined in the behavioral health section of your plan.
Even if your plan is limited or lacking when it comes to therapy sessions from a psychiatrist or psychologist, your plan may pay for at least a certain number of visits to a certified mental health counselor. The American Mental Health Counselors Association, or AMHCA, says that many plans offer reimbursement for clinical mental health counselors, although you may need pre-approval or a referral, or visit only approved counselors on your health insurance company’s list.
Mental health counselors differ from psychologists and psychiatrists due to their educational backgrounds. Although they may not be required to undergo the same type of training as other mental health professionals, most states offer mental health counselor certification that requires them to meet a number of other requirements.
Mental health counselors can provide some of the same type of services as other therapists but usually at a lower cost. They may be able to provide clinical mental health assessments and diagnoses, treatment for substance abuse and alcoholism, and various types of therapy.
Psychotherapy may be an option, as may additional prevention programs other than those covered by the Affordable Care Act. Mental health counselors can set up therapy plans and offer additional therapeutic methods that are geared at managing a crisis or focused on a solution to a specific issue. Mental health counselors may also provide education on a variety of mental health issues to help you learn more about specific problems and what types of treatments are available.