Am I Covered? Navigating Insurance Coverage for Mental Health

November 18, 2024 By Jacob Nuckolls Coping Skills, Insurance, Mental Health

Navigating insurance coverage can feel daunting. When you’re already struggling with your mental health, it can feel like finding a provider who takes your insurance is just another barrier to feeling better.

But there is hope. In this article, we’ll give a simple guide explaining what insurance coverage looks like and how to make sure you’re maximizing your insurance benefits in order to make mental health care as affordable as possible.

What is Insurance Coverage?

First, let’s unpack what insurance coverage means and what it looks like.

Insurance coverage refers to the services your plan includes. While some services, like routine check-ups, may be covered, others might not be, such as cosmetic surgeries. Keep in mind, though, that insurance coverage doesn't guarantee the company will pay directly for each service. If you have a deductible (an amount you have to pay before your insurance starts paying), your appointment may apply toward that deductible, requiring you to cover the cost until it's met.

Also, it’s important to note that some insurance plans don’t have mental health benefits and won’t pay for therapy, psychiatry, or other mental health services. Please be sure to call the member services number on your insurance card to make sure you have mental health benefits!

Once you've confirmed you have mental health insurance coverage, it’s best to choose an in-network provider who accepts your insurance.

What Does In-Network Mean?

In-network means that a doctor, therapist, or clinic has an agreement with your insurance company. Because of this agreement, it usually costs you less to see them compared to an “out-of-network” provider, who doesn’t have the same agreement.

When you choose an in-network provider, your insurance company covers more of the costs, which can make getting care more affordable.

Now, let’s get into how to find a mental health provider who is in-network with your insurance.

How To Find Someone Who is In-Network With Your Insurance

The first thing to remember about finding a provider who is in-network with your insurance is that it never hurts to ask! No one expects you to be an insurance expert, so please feel free to ask the person who’s scheduling you for an appointment if your provider is in-network with your insurance.

At Nystrom & Associates, our intake team verifies your insurance and finds an in-network provider for you. Our insurance team will call your insurance company to check as well.

If You Don’t Have Insurance

Now, what if you don’t have insurance?

Thankfully, there are several options for finding affordable therapy if you don’t have insurance coverage for mental health or don’t have insurance.

Sliding Scale Fees. Many providers, including Nystrom & Associates, offer sliding scale fees based on income, reducing costs for those who qualify.

Community Mental Health Centers. Local community centers often provide low-cost or free services for eligible individuals. Check with your local health department for resources.

Nonprofit Programs. Organizations like NAMI and Mental Health America can connect you to low-cost resources, support groups, and additional services.

Employee Assistance Programs (EAPs). Many workplaces offer EAPs, which cover a few free counseling sessions for employees.

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). Using pre-tax dollars to reduce out-of-pocket costs, you can use HSAs and FSAs for therapy and other health expenses.

A Word from Nystrom & Associates

If you or someone you know is struggling with their mental health but not sure if we take their insurance, please reach out.

Contact us at 1-844-NYSTROM or request an appointment online. We’ll help you find a therapist, psychiatrist, or other mental health provider who accepts your insurance.