A Guide to Your Health Plan Resources and More

Covered California Mental Health Coverage

From traditional talk therapy to telemental health visits, here are your mental health resources through your Covered California health plan. 

 

With so many things weighing on our minds these days—from stressors related to the COVID-19 pandemic to back-to-school stress — managing your mental health can often take a backseat to the rest of your life. Experiencing these events has been painful for many, particularly those experiencing loss, isolation, grief, and many other emotions.

 

There will always be bumps in the road, so it’s important to build a mental health routine that will help support you whether you're in the midst of a crisis or just managing the stress of day-to-day life.

 

The National Institute of Mental Health reports that almost 1 in 5 U.S. adults live with a mental illness, which includes various conditions and degrees of severity. According to the Centers for Disease Control, one-third of Americans showed signs of clinical anxiety or depression as a result of the pandemic. Lastly, the American Foundation for Suicide Prevention states that suicide is the 10th leading cause of death in the United States, with approximately 4.8% of adults aged 18 and older reporting that they have experienced.) serious thoughts about suicide in 2019.

 

Mental Health Coverage is an Essential Health Benefit
 

Your mental health is just as important as your physical health. That’s why federal law, under the Affordable Care Act (ACA), says that mental and behavioral health services are essential health benefits that must be covered. These include behavioral health treatment, like counseling and psychotherapy; inpatient mental and behavioral health services; and substance use disorder treatment. All ACA-compliant health plans cover nearly all mental disorders, as well as substance use disorders and treatment for alcohol and chemical dependency.

 

In addition, federal law requires certain protections for mental health and substance use disorder benefits to ensure they are covered in the same way as most medical and surgical services. This means that things like deductibles, limits to days or visits covered, or the way care is managed must be the same for mental health and substance use as they are for other medical benefits.

 

California law provides added security by requiring every health plan in the state to cover certain mental health conditions, including the following:

  • Major depressive disorders

  • Autism or pervasive developmental disorder

  • Bipolar disorder

  • Panic disorder

  • Schizophrenia

  • Schizoaffective disorder

  • Obsessive-compulsive disorder

  • Anorexia nervosa

  • Bulimia nervosa

  • Serious emotional disturbances in children under age 18

 

These are all serious conditions that deserve immediate treatment. Care is available for everyone, and having a health plan makes that care even more affordable and accessible. A health plan must cover outpatient diagnosis and treatment, inpatient hospital services, partial hospitalization, diagnosis, outpatient services and prescription drugs (if your health plan covers prescriptions), with the same terms as any other medical condition.

 

Start Your Path to Treatment

If you are in need of care, you can start your path to treatment today. The sooner you have support, the sooner you can begin to heal. For some health plans, you can make an appointment directly with a mental health care provider, but for others, you may need a referral from your primary care physician or your health plan. Check your insurance company’s website or call the number on your membership card to find out more. Some plans have a behavioral health phone number that you can call directly. Remember, it’s important to ask for help — and help is available for you and your loved ones.

 

Not sure where to start? Try the Behavioral Health Treatment Services Locator. It’s a completely anonymous and confidential resource for anyone seeking treatment for substance use disorders or mental health issues in the United States. If you feel you are at risk of harming yourself, please call the National Suicide Prevention Lifeline at (800) 273-8255, available 24 hours a day, 7 days a week.

 

If you aren’t currently covered, call us today at (800) 650-0922 to enroll. Or, visit a Covered California Center in your area. To see our locations, visit here. Or, you can use our Shop and Compare tool to help you find out which health plan options are available to you.


 

Sources:
Covered CA

Oscar Health