Will Health Insurance Pay for a Psychiatrist?
Your health insurance may pay for you to see a shrink, or it may not. It all depends on the type of plan you have and the coverage it provides. It also depends on how your health insurance company deals with the treatment of mental health issues and the steps you have to follow to receive such treatment. Even if your health insurance does pay for you to see a psychologist or psychiatrist, your choices and number of visits may be limited under the plan.
How Might My Mental Health Insurance Choices Be Limited?
Health insurance companies may only cover services offered by providers on their list. This may apply to the provider of physical health care as well as mental health care. Health insurance companies may also only cover certain types of providers, such as a psychiatrist but not a licensed counselor. The general slang term of “shrink” is most likely not mentioned in your health care plan, so you would need to figure out what type of therapy your treatment involved.
What types of “shrinks” are there?
Mental health care providers come in several varieties, depending on their qualifications and conditions they typically treat. The University of Colorado outlines the four basic types of providers, all of which may take on the role of psychotherapist role.
Psychotherapy is simply the term used to describe treatment for mental health issues by speaking with a mental health provider. A psychotherapist is simply someone trained to be that provider. The four main types of providers are psychiatrists, psychologists, social workers and counselors.
Psychiatrists are the only one of the bunch who are medical doctors with an educational background in medical schooland at a least a three-year psychiatric residency. They are also the only ones qualified to prescribe medication.
Psychologists hold a doctorate degree in psychology and an educational background in therapeutic techniques, human behavioral theories, and research in the field.
Social workers hold a master’s degree in social work and a background that includes two years of training and education in the field.
Counselors generally are certified, licensed or have focused advanced studies and hold an advanced degree in their specific field. Fields may include alcohol counseling, guidance counseling, or psychology.
What Else Should I Know Before Booking an Appointment?
Reviewing your specific health insurance plan may help ensure you are not stuck with the full cost of your visit to a mental health care provider, advises Mental Health America.
Check with your provider to find out what costs are covered and if you need a referral from your primary care doctor or pre-approval from the health insurance company to receive the coverage. If your health insurance company allows you to seek help from mental health providers outside of its network, find out how much that would cost versus choosing from providers in an existing network.
You may also be limited by the number of visits you may receive per year or the dollar amount you’ll be reimbursed under your plan, with any additional visits paid fully out of your own pocket. Similar to health care providers for physical health issues, many plans may also require a co-pay for each visit to a mental health care provider.
Researching the cost of outpatient versus in-patient treatment is also important, especially if a mental health care provider recommends an in-patient treatment plan for your particular issues.
Two additional points that may come up include diagnoses and medication you plan covers. Certain insurance companies may only cover specific diagnosis and they may not cover any diagnosis that was a pre-existing condition prior to your policy going into effect.
Medication is typically covered by prescription plans offered by health insurance companies, so finding out the details on the prescription benefits is a good idea if you are prescribed medication.
Health insurance plans may place limitations on how you receive your medication, such as by a mail-order vendor only, and they may also have set formulas for calculating the cost of various types of medication. A generic drug, for example, is usually the cheapest option since it has been around for several years while a name brand drugs are typically more expensive. Name brands may fall into the non-preferred or preferred category, with the latter often available to plan members cheaper than you would pay retail.
How do Health Insurance Companies Deal with Mental Health Coverage?
Health insurance companies may take several routes when dealing with coverage for mental health issues, according to Mental Health: A Report of the Surgeon General.
Your health insurance coverage may not include any provisions for mental health issues, or it may provide equal coverage for mental and physical health issues. Another option is what the Surgeon General report calls a carve-out, where mental health coverage is provided by a different vendor.
In the case of a carve-out, you may automatically be enrolled for mental health coverage under a different vendor or you may have to specifically enroll on your own and pay separately for the additional coverage.