Insurance Coverage Guide

Understanding your mental health insurance coverage can save you time, money, and stress.

Your Rights Under Federal Law

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires most insurance plans to cover mental health and substance use services at the same level as medical and surgical care. This means your copay for therapy can't be higher than for a doctor's visit.

What's Typically Covered

  • Outpatient therapy – Individual, group, or family counseling sessions
  • Inpatient treatment – Hospital stays for mental health crises
  • Medication – Psychiatric medications prescribed by a doctor
  • Substance use treatment – Rehab and addiction counseling
  • Case management – Help coordinating your care

Key Terms to Know

In-Network vs Out-of-Network

In-network providers have agreements with your insurance company and cost less. Out-of-network providers may cost more or not be covered at all. Always check before your first appointment.

Deductible

The amount you pay out-of-pocket before insurance starts covering costs. For example, if your deductible is $1,000, you pay the first $1,000 of therapy costs yourself.

Copay vs Coinsurance

Copay: A fixed amount you pay per session (e.g., $30 per therapy visit).
Coinsurance: A percentage of the cost you pay (e.g., you pay 20%, insurance pays 80%).

Session Limits

Some plans limit the number of therapy sessions per year. If you hit the limit, you'll pay full price for additional sessions. Ask your insurance company about limits before starting therapy.

Questions to Ask Your Insurance

  • Does my plan cover mental health services?
  • Do I need a referral from my primary care doctor?
  • What's my copay or coinsurance for therapy?
  • Is [specific therapist] in-network?
  • How many sessions per year are covered?
  • Does my plan cover telehealth therapy?
  • What's my deductible, and have I met it this year?

Can't Afford Your Copay?

Even with insurance, therapy can be expensive. We provide grants to cover copays, deductibles, and out-of-pocket costs.

Apply for Grant