Call your insurance plan, or your company’s benefits administrator, and ask for a verbal and written description of what coverage is provided for behavioral health treatments. Many insurers offer coverage for mental health (MH) services and/or substance abuse (SA) treatments; some only cover substance abuse if it co-occurs with mental illness. If you plan to use MH or SA benefits through your insurance plan, you may be required to get a referral from your regular doctor before you can receive services.
Additionally, your employer may offer an employee assistance program, or EAP. An EAP is a resource provided either as part of, or separate from, employer-sponsored health plans. Usually EAP visits are free, but the number of visits may be limited. Preventive care measures such as health screenings, mental health or substance abuse screening, and/or wellness activities will be provided. An EAP may not include all services and programs, but many provide aid to employees and their families for substance abuse, stress, depression, and other mental health issues. EAP visits are confidential; information discussed in these visits will not be shared with your employer.
If you do not have access to an EAP or employer-sponsored health insurance, you may qualify for Medicare or Medicaid services. To determine your eligibility for these and other government programs, and to determine what kinds of coverage are provided, contact the Centers for Medicare and Medicaid Services (CMS), www.cms.gov, at 1-877-267-2323 (TDD: 1-866-226-1819) and your State’s department of insurance. On the web, you can find contact information for your State’s department of insurance onhttp://www.naic.org/state_web_map.htm. You can also find contact information for your state’s mental health program from the National Association of State Mental Health Program Directors at http://www.nasmhpd.org/members.cfm.
Your State mental health agency will be helpful in telling you how mental health services in your State are funded. In publicly funded mental health centers, such as those run by State, city or county governments, the cost of many services is calculated according to what you can afford to pay. So, if you have a lack of funds, services are still provided. This is called a sliding-scale, or sliding-fee, basis of payment. In addition, States, which often work with Federal programs, such as Medicaid, provide financial assistance to eligible individuals or families. Information about medical and health care assistance is available at your county/city social services departments, health and human services department, or Social Security office.
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