Know what mental health services your insurance covers

“The Affordable Care Act, also known as the ACA or ‘Obamacare,’ ensured that most individual, family and employer group plans cover mental health and substance use services as essential health benefits,” says Don Truong, director of sales at Sharp Health Plan.

Additionally, health plans in California are required by law to cover certain treatments, such as psychotherapy and counseling; mental and behavioral health inpatient services; substance use disorder treatment; and more.

“Preexisting mental health and substance use conditions are covered too,” Truong adds. “And health plans cannot put limits on coverage of these essential health benefits."

Medicare, the federal health insurance program for people who are age 65 or older and certain younger people with disabilities, also covers counseling, inpatient services and substance use disorder treatment.

Medicare Advantage Plans, which are "bundled" plans offered by Medicare-approved private companies, vary in the mental health services they cover. You can compare the quality of Medicare health and drug plans using Medicare's Star Ratings system, which rates plans on a one-to-five scale.

If you have Medi-Cal, California’s Medicaid program, contact your County Mental Health Department to find services. Employer-sponsored coverage, in which your employer offers health insurance to you and your dependents, also offers benefits. Reach out to your employer's human resources or benefits department for more information.

Dr. Arian and Truong recommend that you take the time to review a plan's network of doctors and the medications covered before enrolling. You also want to familiarize yourself with the level of customer service that plans provide.

"It’s important to do your research about the doctors and therapists within a plan's network, as well as the services and medications covered," Truong says. "For example, Sharp Health Plan makes it easy to get care, with thousands of behavioral health providers for our members to choose from."

Dr. Arian adds that many health plans, including Sharp Health Plan, offer telehealth services. “Video visits offer a convenient way for you to access care confidentially from the privacy and comfort of your own home,” Dr. Arian says. “What’s more, with Sharp Health Plan, no referral is needed for outpatient therapy with a provider in your network.”