Best health insurance for mental health coverage in California

Best health insurance for mental health coverage

Health insurance for mental health coverage In America, about one in five persons suffer from mental health illnesses; of those, 14.4% have sought therapy in the past 12 months. But it’s believed that more than half of all Americans with mental health issues don’t receive any kind of medical care. Regardless of your financial situation, you may always take the initiative to acquire coverage and begin your journey to wellness.

All Californians are eligible for coverage under the Affordable Care Act (ACA) and Covered California since mental health services are one of the country’s top ten essential health benefits. No matter their financial situation, Health for California is dedicated to educating Californians about affordable mental health treatment. Health for California has information on how to begin your path to greater mental health and affordable treatment alternatives.

Coverage of Mental Health in California

All California and federal health care plans now include coverage for mental health and substance use disorders because it has been determined that such coverage is necessary since 2010. You can no longer be denied insurance coverage because of existing mental health disorders or be charged more than those who don’t, thanks to the ACA. As required by the ACA, you must:

  • Become a member of a qualified health plan.
  • When filing taxes, include a mandate for exemption.
  • Pay a fine for not having insurance (if uninsured for more than three consecutive months).

There is a separate open enrollment time for new patients for each health insurance plan. Open enrollment periods for plans covered by the Affordable Care Act run from November 1 through January 15 each year. Before December 15th, you must enroll in a plan in order to have coverage for the start of the year. Every year, from October 15 to December 7, the open enrollment period for Medicare is held.

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What Does Mental Health Insurance Cover?

Health insurance policies that include mental health care often cover a wide range of services. The following are some of the services that the top mental health insurance plans cover:

  • Talk therapy
  • Inpatient hospitalization
  • Partial hospitalization
  • Treatment for substance abuse
  • Emergency services
  • Medication

What Doesn’t Mental Health Insurance Cover?

While many health plans offer extensive coverage for mental health, some treatments, such as experimental therapies and services that are not medically essential, may be excluded. The list of exclusions will vary depending on your particular insurance plan because every insurance plan is different.

Here are some mental health services that are typically not covered by health insurance policies:

  • Treatment for addiction or mental illness that is not medically essential
  • Halfway houses
  • Genetic testing for psychotropic medication
  • Attempting new treatments
  • Getting treatment on the advice of a third party, such as an employer or a school
  • Educational initiatives for mental health or addiction (such as wilderness therapy)
  • Long-term care for addiction or mental health
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Health insurance typically won’t pay for mental health interventions that aren’t clinically necessary or linked to a medical diagnosis. For instance, if a person is not having a clinical mental health illness, such as anxiety or depression, as a result of the event, a health insurance plan may not pay for counseling for bereavement or a significant life transition.

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Best Health Insurance Plans For Mental Health

1. Medi-Cal

One in three Californians are covered by Medi-Cal, the state’s Medicaid program. Many low-income people can get it, including some legal immigrants and illegal children. You may be eligible for full-scope Medi-Cal or partial Medi-Cal, which only covers some services, depending on the type of coverage you need. Even some dental or vision benefits can be available to you. If you are eligible, Medi-Cal might be a great method to get access to low-cost mental and behavioral health care.

2. College advisors

Your college’s campus health center might provide mental health services with trained counselors if you’re a student. Often times, full-time students are not charged for these services. Students who require support with stress management, anxiety, despair, substance addiction, or even career uncertainties may find an accessible choice in on-campus counseling.

3. Covered California Metallic Benefit Plan

Health insurance policies were reorganized into four tiers: Bronze, Silver, Gold, and Platinum when the ACA went into effect in California. To demonstrate patient-centered plan designs and medical cost sharing, Covered California goes beyond these distinctions. All Metallic Benefit Plans, as defined by the ACA, provide coverage for the 10 Essential Health Benefits, including services for mental health and substance use disorders.

Each Covered California Metallic Benefit Plan reflects the overall percentage of costs that the health insurance company covers. As an illustration, a Bronze 60 plan pays for 60% of costs, but a Platinum 90 plan covers 90% of costs.

health insurance for mental health coverage

4. Nonprofit organizations

Using toll-free hotlines, several charitable groups offer free assistance with addiction and mental health issues. These hotlines offer crisis care around-the-clock and can direct callers to nearby treatment facilities. The following resources are accessible worldwide:

  • National Helpline for SAMHSA
  • Hotline for NAMI (National Alliance on Mental Illness)
  • 988 Suicide and Crisis Lifeline
  • The Trevor Project

5. Medicaid

Low-income Individuals can use Medicaid, a federal and state-funded health insurance program. You must meet the state’s income standards in order to qualify for Medicaid. Individual and group counseling, partial hospitalization, medical detox, residential treatment, and pharmaceuticals are just a few of the mental health and substance misuse disorder therapies that Medicaid will pay for.

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6. Employee Assistance Program

A tool that assists people in resolving personal concerns that are impairing their performance at work is the Employee Assistance Program (EAP). This program offers counseling and therapy for a range of problems, including drug misuse, money troubles, and interpersonal difficulties. Nevertheless, you can only take use of an EAP if your company does.

7. Veterans Affairs

There are numerous methods to benefit from mental health treatment services if you had military service. Even for those who are not enrolled in VA Healthcare, the VA provides free individual and group therapy as well as substance misuse treatment programs for war veterans. You have access to more extensive mental health treatment benefits if you have VA Healthcare.

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8. Therapy apps

If you don’t have mental health insurance, you might think about trying a counseling app. With the help of these mobile apps, you may reach out to a qualified mental health expert whenever it’s most convenient, either virtually or over the phone. Instead of charging per the session, many apps, including Talkspace and BetterHelp, require a monthly fee.

Do All Health Insurance Providers Have to Provide Mental Health Coverage?

The provision of mental health coverage by health insurance companies is not mandated by law. Instead, according to the federal parity rule, insurers who offer mental health coverage are required to offer mental health/substance use disorder treatment that is at least as good as physical health coverage.

Is the price of health insurance higher if it includes mental health benefits?

Health insurance policies that cover mental health are not always more expensive than policies that do not. In reality, one of the ten essential benefits for some health insurance plans, such as those sold through the ACA marketplace, is the provision of mental health treatments.

Does Medicare provide coverage for mental health?

Mental health is covered by Medicare, including Medicare Part B, which pays for individual counseling, mental health exams, short-term inpatient stays, and drug administration. Inpatient mental health care is covered by Medicare Part A, generally known as hospital coverage. Most prescription drugs for mental health treatment are also covered if you have Medicare Part D. Moreover, Medicare Advantage, often known as Part C, may provide increased mental health benefits beyond what is provided by Parts A and B.

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What makes up the cost of Health Insurance?

The cost of medical care that covers mental health issues varies depending on a number of variables, such as your region, your insurance provider, and the kind of plan you select. To discover the finest mental health insurance with the lowest rate, you can compare several insurance quotes.


In California, 1 in 6 persons have a mental disease of some description, and 8% are classified as having a substance use disorder. Just one-third of persons who require mental health care actually obtain them, though. Just 10% of people with substance use disorders receive the necessary treatment, which is an even lower rate. The good news is that if you have health insurance, laws exist to make sure that you and the people you care about receive the treatment you need to recover.


Does regular health insurance include coverage for mental health care?

Many common health insurance policies include coverage for mental health care. Treatment for mental illness and substance misuse must be covered by health plans sold on the Affordable Care Act marketplace. Other additional health plans, including those provided by employers, Medicare, and Medicaid, also include benefits for mental health.

Can pre-existing conditions prevent you from getting coverage?

The majority of the time, a health insurance provider cannot refuse coverage due to a pre-existing condition like cancer, heart disease, diabetes, or a mental health disorder.

Can You Get Standalone Mental Health Insurance?

Although many health insurance policies include coverage for mental health treatment as one of the benefits, insurance firms do not provide standalone mental health insurance plans.

How do I get mental health assistance in California?

If you require emergency assistance due to a mental health crisis, dial “911” and describe your situation to the operator. Many mental health programs for children and youth, adults, and older adults are managed by the Mental Health Services Division (MHSD).

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