Step 1: Recognize Your Rights
The Metal Health Parity Law requires insurance companies to provide coverage for mental health and substance use disorder treatment that is equal to, or better than, medical/surgical coverage.
In a survey conducted by the American Psychological Association (APA), only four percent of Americans say they are aware of the Mental Health Parity and Addiction Equity Act of 2008, which requires mental and behavioral health coverage to be equal to or better than coverage for physical health, with no annual limits or higher co-pays or deductibles for treatment of mental health disorders or substance use. The law applies to most employer-provided health plans and to individual plans purchased through state and federal health insurance exchanges (APA, 2016).
Click here to access Empower Idaho’s Mental Health Parity Awareness Campaign.
Click here to access NAMI’s Parity Infographic with more information.
Step 2: Review your insurance policy
Find out the types of mental health services that are covered, the cost for these services, and any steps you must take to have treatment covered. Your insurance may require a referral from a primary care physician in order for you to receive mental health services. Even if you have a copy of the plan, it’s always helpful to speak to someone and clarify any questions you might have. This way you can identify any possible points of confusion before you receive a bill. You should have a phone number on your insurance card or on the insurance company’s website that will tell you who to contact. They can also help you find a provider.
Step 4: Search mental health providers/counselors in your area
You may need a provider that’s in your insurance company’s “network”. The best way to find in network providers is to go on your insurance company’s website and use the search tool they provide. If convenience is important to you, search in the area of your home, work, or where you spend the majority of your time. You can narrow providers by who will be most convenient to see. Once you’ve narrowed it down to 3 or so, we suggest visiting the website of each provider to see who is the best fit. Sometimes this process is trial and error and we suggest going with the provider that seems most appealing.
Step 5: Call to make an appointment
Step 6: Go to your appointment
Step 7: Be consistent and proactive
If You Don’t Have Insurance
Enroll in The Health Exchange
If you don’t have health insurance through a job, Medicare, Medicaid, or another source, the Health Exchange may help you get covered. What you will pay for insurance depends on your income and you can apply for coverage online, by phone, with in-person help, or with a paper application. Visit Your Health Idaho to learn how to enroll. Open enrollment for the health exchange has ended but life changing events my qualify you for a special enrollment. Learn more here.
Contact Your Department of Health & Welfare Regional Behavioral Health Office
The State of Idaho provides state funded and state operated community based mental health care services through Regional Behavioral Health Centers (RBHC) located in each of the seven geographical regions of the state. Each RBHC provides mental health services through a system of care that is both community-based and consumer-guided. Visit their website to learn more, to find your regional center, and to find an application for adult mental health services.
Apply for Medicaid
Medicaid helps low-income individuals in certain groups pay for medical care and prescriptions. Medicaid is not a typical insurance program with monthly payments and deductibles. Medicaid pays providers directly for your care. Low-income beneficiaries aren’t the only group to receive Medicaid, as there are several other qualified groups that are covered (although some of this will change in upcoming healthcare reform). In order to receive health coverage from Idaho Medicaid, you must complete the application process and meet certain eligibility requirements. Click here to learn more and apply if you are eligible. Call 1-877-456-1233 for more information.
Pay Out of Pocket
Paying for mental health care out of pocket can be expensive but some providers offer low cost services. When seeking out a mental health professional it’s ok to talk about cost, and many counselors offer sliding scale or bro bono rates. It may take several phone calls to find the counselor you can afford, but it’s worth it! You can do a google search such as “low-cost mental health providers” in you place of residence. Local behavioral health boards and recovery centers may also be able to assist with finding low-cost services.