Check your description of plan benefits — it should include information on behavioral health services or coverage for mental health and substance-use disorders. If you still aren't sure, ask your human resources representative or contact your insurance company directly.
Psychologists and other mental health providers can choose whether or not to accept insurance. Unfortunately, many insurance companies have not increased the reimbursement rate for psychologists in 10 or even 20 years despite the rising administrative costs of running a practice. Other companies have recently cut their reimbursement rates. As a result, some plans have trouble attracting mental health professionals to participate in their networks. If your options seem limited and your insurance is provided through your employer, you might consider discussing your concerns with your human resources representative. He or she may take that into consideration when negotiating your company's plan with insurance companies in the future.
If your health plan covers out of network providers for mental health services and you are seeing a mental health provider who does not accept your insurance, complete your insurance claim form and submit it along with the mental health provider's invoice to get reimbursed. If you are unsure about your health plan's claim procedures for out of network providers, contact your insurance company.
If you have concerns that your plan isn't complying with the parity law, ask your human resources department for a summary of benefits to better understand your coverage, or contact your insurance company directly. Your human resource department can provide you with information about your coverage and may be able to put you in touch with a health care advocate who can assist in making an appeal. If other employees are having similar issues, your HR department may wish to keep track of the problems and work with the insurance company to ensure that benefits are meeting employee needs. If you do not have an HR department or if your insurance is not provided by your employer, you may wish to speak with the insurance company directly. To reach out to your insurance company, check for a customer-service number on the back of your insurance card. If you obtained your insurance through an insurance exchange, you may be able to get help from your state insurance commissioner.If you still have unanswered questions or wish to file a parity complaint, visit the U.S. Department of Labor's Employee Benefits Security Administration (EBSA) Consumer Assistance web page — from there you can click on “Ask a Question,” “Submit a Complaint,” or “Report a Problem.” You can also call the EBSA toll-free consumer assistance line at 866-444-3272. The federal government's Consumer Assistance Program webpage is another good resource.
Check with your human resources department or insurance company for specific details about your coverage. Here are some important points to consider:
Credit given to the American Psychological Association