How to Navigate Mental Health Insurance in College

You should always seek professional help if you are feeling stressed, overwhelmed, anxious or depressed. Financial concerns should not prevent you from that getting help. There are options and people available to assist you with your brain health challenges 24/7. With that being said, navigating insurance can be a tricky process at times. Below I have laid out for you the basic guidelines for navigating ‘mental’ healthcare with and without insurance.

If you have insurance:

You or your parents insurance provider may pay for brain health care not covered by your student fees, which could include long-term counseling, emergency room visits and medication. Insurance policies vary in how much and the type of brain health care they will pay for. Therefore, it’s important that you begin your wellness journey by going to your providers health plan website. There,  you will be able to see which ‘mental’ healthcare providers are in-network, the associated costs, and any benefit limitations. Insurance companies are required by law to offer comparable coverage for brain and physical healthcare coverage under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act.

Before moving onto campus, call the number on you or your parents insurance card and ask:

  • Does my insurance policy pay for ‘mental health’ services in (name your campus or surrounding towns)?
    • This is important because many insurance policies only cover treatment in certain areas
  • What type of ‘mental health’ services are paid for by my current insurance policy? (ex. Office visits, medication, etc.)
  • Is there a ‘preferred list of providers’ I have to choose from? What is the process if I want to see someone ‘out-of-network’?
  • Is there a limit on the amount of covered visits to see a ‘mental health’ professional?
    • Insurance policies will often limit how many counseling sessions they will cover in a year
  • Will my insurance plan pay for the services I require? If so, how much of the cost will they cover?
    • You might be responsible for paying co-pays (I was) or deductibles
  • Do I need any approvals before the services are provided?
    • This could mean a referral from your general practitioner

When calling to schedule an appointment, ask the facility where you plan to receive care from the following questions:

  • Do you accept my insurance?
  • Will you bill my insurance company?
  • How do you bill for treatment?

In my case, I had to pay the entire bill upfront and then was reimbursed by insurance company afterwards. This process was not streamlined or easy, but it was worth it. I would look at this as an investment in your health and well-being. It will pay-off in the long run as you start to feel better.

 

If you don’t have insurance:

When making the decision to invest in your well-being by seeking care, remember that most institutions of higher learning offer free brain health services through the Counseling and Psychological Services Center (CAPS). They will typically offer anywhere between 10-12 sessions a year.

If insurance is not obtainable, you can seek help at a local social services agency, or a Federally Qualified Health Center (community-based healthcare centers that are funded by the government). You can do this by Googling ‘community-based mental health services in my area’. There you should find low-cost, affordable options outside of what your school is offering. Call them directly to understand what the process is to receive services if you don’t have insurance.

When calling the facility you would like to receive care from, you should always ask if they offer a sliding scale fee. A sliding scale fee is when a provider makes arrangements to meet your financial circumstances by adjusting the cost they charge for certain services. If a sliding scale fee is an option, you might need to bring proof of income like a tax form for your entire family to your first appointment. Ask the clinic what if anything you need to bring for your first appointment.

There are additional resources that I have provided at the end of the book that you can utilize for support. One example of that is the National Alliance on Mental Health (NAMI). They have a helpline that offers free help 24/7. All you need to do is text NAMI to 741741.

 

Paying for Medication:

If you are trying to determine how to pay for medication, talk with the doctor prescribing you. They can work with you or direct you to someone who can help determine any available medication assistance programs. As part of that process, you might consider purchasing the generic brand of your medication if one is available. Make sure to ask your clinician during your visit if a generic brand is available. In addition, you can ask your pharmacy if they have discount prescription programs. Major retailers like Walgreens may offer discount programs for generic psychiatric medications.

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