You may be familiar with the ways your insurance plan covers doctor’s appointments for your physical health – but did you know you have coverage for mental health too? Your mental health is just as important as your physical health, and often the two affect each other.
Here are some tips to understand your benefits.
Mental health and physical health services must be covered equally
In 2008, the Federal Parity Law – formally known as Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act - was passed. This law requires services for mental and behavioral health, as well as substance-use disorders to be comparable to medical/surgical services. The law also states that they number of outpatient or inpatient visits must be comparable to medical/surgical visits, meaning your insurance company can’t limit the amount of mental health related visits you have per year. Lastly, prior authorization requirements must also be comparable to medical/surgical requirements.
Check your plan benefits to see what is covered
Although all plans must make mental health services comparable to surgical services, it is still important to understand exactly what is covered. The parity law requires comparable coverage only if mental health benefits are provided. Most plans offer mental health services, but it is still important to check what is covered.
Your plan benefits will include a description of the coverage for mental health, substance use disorder and behavior health services. If you still don’t understand your coverage, log in to your online member account at bcbsm.com or through the Blue Cross mobile app.
Blue Cross Blue Shield of Michigan and Blue Care Network can help members find an in-network mental health professional by calling behavioral health access lines listed below:
PPO: Behavioral Health Access Line | 1-800-762-2382
- A free and confidential resource that’s just a call away when you need immediate support. Behavioral health professionals answer, 24/7.
HMO: Behavioral Health Access Line | 1-800-482-5982
- Connect with a behavioral health clinician if you need help finding a mental health or substance use provider.
- Behavioral health clinicians are available for routine assistance from 8 a.m. to 5 p.m., Monday through Friday. For urgent concerns after hours, clinicians are also available 24 hours a day, seven days a week.
Learn more about mental health and options you have as a member to seek help at bcbsm.com/mentalhealth.
Steps to ensure your mental health services are covered
In case you read your plan, and still don’t fully understand what is and isn’t covered, here are some steps you can take:
- Check to make sure your mental health provider is in your network/is covered.
- Ask about copays and deductibles. Although comparable coverage to medical/surgical services is required by the parity law, it is important to understand your coverage and costs.
- Talk to your insurance provider. If you still don’t understand what is and isn’t covered, that’s ok. Your insurance provider can help you understand what your coverage includes.
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