Key Takeaways
- Most major health insurance plans are legally required to provide coverage for some form of psychiatric care.
- To verify your mental health benefits, log into your insurance website, check your plan documents, or call the number on the back of your insurance card.
- If you’re uninsured (or your plan doesn’t cover psychiatry), many community mental health clinics, teaching hospitals, and individual providers offer low-cost or sliding-scale psychiatric support.
Mental health parity laws have broadened access to psychiatric services and other forms of mental healthcare in recent years. But health insurance remains complex. It isn’t always easy to know which psychiatric services are covered by your policy and how much treatment will cost.
While your exact benefits will vary based on your plan, it’s important to understand the limitations of your coverage before accessing care. Knowing what is and isn’t covered can help you avoid surprise bills and ensure that you’re making the most of your health insurance plan.
What kind of insurance covers psychiatry?
Today, the vast majority of insurance plans cover psychiatric care as part of their mental health benefits. If you have insurance through any of the following, your plan is legally required to provide mental health coverage that’s similar to the coverage it provides for physical healthcare:
- Employer-sponsored health coverage
- Coverage purchased through health insurance exchanges, marketplace plans, or Healthcare.gov
- Children’s Health Insurance Program (CHIP)
- Most Medicaid programs (requirements can vary by state)
- Tricare (coverage for veterans and active-duty service members)
Keep in mind that, even with these plans, psychiatric care coverage isn’t universal, and there are some exceptions to be aware of.
For example, your employer isn’t required to provide health insurance unless they employ more than 50 people. So you may not be eligible for employer-sponsored insurance if you work for a smaller company. Also, some state government employee plans (like those that cover teachers and employees of state universities) aren’t subject to federal parity law.
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What does psychiatric insurance usually include?
Psychiatrists provide support throughout your mental health journey. Your insurance may cover:
- Assessments and evaluations
- Outpatient services, like therapy
- Telepsychiatry (virtual care)
- Medication management
- Inpatient services
- Substance use disorder (SUD) treatment (also referred to as behavioral healthcare)
- Psychiatric hospitalization
- Emergency or crisis care
Having these psychiatric services covered by your plan doesn’t necessarily mean you won’t have an out-of-pocket cost to access them.
So, if possible, before seeking support, take some time to determine your plan’s deductible, copay and coinsurance fee structures, pre-approval requirements, out-of-pocket maximums, and which facilities and providers are in network. Knowing the limitations of your coverage can help you make a more informed decision about engaging with care.
How to find out if your plan covers a psychiatrist
The following steps can help you determine whether your health insurance plan covers psychiatric services. If you’re shopping for a new health insurance plan, you can contact potential insurers with questions before you purchase coverage.
- Log in to your member portal. Most major insurance companies allow you to create an account on their website and sign up for a member portal from which you can access detailed information about your coverage. Some insurers even have apps you can download to your smart devices.
- Check your explanation of benefits (EOB). This document — also referred to as your summary of benefits and coverage (SBC) — outlines things like which psychiatric medications your plan covers; limits on the number of times you can see a psychiatric provider within your benefit period; which providers and facilities are in network; limits for inpatient and outpatient services; coverage for out-of-network care; and details about which forms of psychiatric support your plan covers.
- Call the number on your insurance card. If you can’t find the information you’re looking for, call the 800 number for members on the back of your insurance card. A representative will be able to view your policy and answer any questions you may have about your psychiatric care coverage. During these calls, take some notes on what the representative shares. Having a record of the conversation can help you advocate for yourself if you need to file an appeal in the future.
What to do if you’re not covered for psychiatry
If you’re unable to access psychiatric care through a health insurance plan, you have some other options to explore. Uninsured or underinsured people may be eligible for low- or no-cost care at their local community mental health center or state or county health and human services (HHS) department.
If you live in an area with a university or teaching hospital, you may be able to work with a psychiatry student. Students are typically supervised by senior clinicians to ensure quality care. Lastly, some psychiatric providers and clinics offer sliding-scale fees. This means you pay a reduced rate for psychiatric services based on your income.
I understand how overwhelming insurance can be to navigate. Sometimes, it may be helpful to call the clinic or provider that you are interested in seeing to ask if they’re in network with your insurance plan. If your insurance does not cover psychiatric care, that’s OK. There are plenty of clinics and providers that take income-based sliding scales. Everyone is entitled to psychiatry care so don’t hesitate to receive it.
Find care with Rula
Due to mental health parity laws, most health insurance plans now cover psychiatric care. But mental health coverage isn’t universal. Sometimes, it can be hard to know what your plan will and won’t pay for. To learn whether your plan covers assessments, medication management, inpatient services, and outpatient care, review your plan documents or call the number on the back of your insurance card. Taking some time to review your policy’s details can help you understand your benefits and make the most of your psychiatric care coverage.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.
About the author
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
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Rula's editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness.
Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
