Mental health insurance is a type of insurance specifically designed to cover behavioral health issues. Certain health insurance companies may offer mental health insurance as a separate, specialized plan while others may offer certain mental health services as part of a general health insurance plan.

What is Covered and Not Covered with Mental Health Insurance?

The exact services covered vary depending on each particular plan, although mental health insurance typically covers treatment and services for behavioral health and substance abuse issues. These generally include a number of mental disorders as well as treatment for alcoholism and drug addiction. Mental illnesses that may fall under the scope of coverage include anxiety disorders, depression, eating disorders, schizophrenia, bipolar disorder and more.

Mental health concerns are conditions that affect your behavior, thinking, and mood. There is a distinction between mental health concerns that may affect everyone from time-to-time and a diagnosed mental illness. The former can become the latter if it begins to affect your daily life, making you unable to function or causing severe stress.

Mental health insurance specifically designed to cover only mental health issues will not typically cover physical illnesses due to trauma, viruses, or other health conditions not stemming from a mental or addiction issue.

How is Mental Illness and Mental Health Treated?

Treatment for mental health issues vary greatly depending on the particular issue being treated. A combination of therapy and medication is a typical mode of treatment for many issues, either on an outpatient or in-patient basis.

Inpatient services that require hospitalization may be a mode of treatment for the most severe issues or those in which patients may be a threat to themselves or others.

Because mental health issues may touch upon three various aspects, namely medical, psychiatric and social, a team approach may be part of a treatment plan. The team approach utilizes the services of a number of health care professionals to provide a well-rounded program that address the various aspects that need addressing. An example of a team approach would be a support network consisting of:

  • Family members
  • Primary physician
  • Psychiatrist who can diagnose mental illness and prescribe medication
  • Pharmacist to fill the medication
  • Psychotherapist who is typically a licensed counselor or psychologist
  • Additional support from social workers if necessary

Such a large team would most likely be involved in treatments for more serious mental illnesses. If you instead suffer from a milder mental health condition, a smaller team consisting of your doctor and a psychotherapist or psychiatrist may be effective.

Medications are not always part of a treatment plan, although they have been very effective for treating certain conditions. Antidepressants have been effective for helping to alleviate sadness and hopelessness as well as improve symptoms that include apathy, malaise and those associated with other conditions. Medications that stabilize your mood may be effective for treating bipolar disorder while anti-anxiety medications may help sooth panic and anxiety disorders.

Schizophrenia and other psychotic disorders are often treated using antipsychotic medications. Antipsychotic medications are also sometimes used in conjunction with an antidepressant to treat depression or for treatment of bipolar disorder.

Psychotherapy is often used in conjunction with medication or on its own for treating a wide variety of mental health conditions. A therapy session typically includes meeting with a mental health care provider to discuss issues relating to your condition as well as your life. Topics of discussion may include your behavior, feelings, thoughts and moods. The point of psychotherapy is to better understand your condition as well as adopt coping skills to deal with it successfully.

One-on-one therapy is common, although you may also meet in a group setting with others who share similar mental health concerns or with family members.

Depression and a few other disorders may also benefit from brain-stimulation treatments such as ECT (electroconvulsive therapy). ECT involves passing electric currents through the brain while transcranial magnetic stimulation uses magnets to create activity in brain cells associated with emotion. Both vagus nerve stimulation and deep brain stimulation use small pulse generators to produce brain activity in the brain’s vagus nerve or deep tissues.

Substance abuse treatments may include the same combination of therapy coupled with medication, and it may include hospitalization and group support sessions.

Does Every Health Insurance Plan Include Mental Health Benefits?

Not every health care plan includes mental health benefits, according to “Mental Health: A Report of the Surgeon General,” as health insurance companies have various ways of dealing with mental health coverage.

An insurance company may offer a limited scope of mental health services under their general health insurance plan, or it may have generous coverage that places mental and physical health issues on equal footing with equal benefits. Another way some companies handle mental health coverage is to enact a cave-out for mental health services, the Surgeon General report explains.

The carve-out can be a payer carve-out where you are required to seek mental health coverage from a plan beyond your general health insurance plan. In this case, you would need to enroll in a separate plan from a mental health care vendor to receive mental health coverage.

The carve-out can also be a health plan subcontract, where the health insurance administrator arranges for mental health coverage through a vendor. In this case, you would not have to enroll in the separate plan to receive mental health coverage.