Yes, most insurance plans cover care from psychiatrists. That said, the degree of coverage can differ depending on your health plan type, the healthcare provider you see, your copay, and your insurer. Generally, insurance policies provide some form of coverage for psychiatric care expenses, like visits to a psychiatrist’s office, medications prescribed, and inpatient hospitalization for mental health treatment.
Exactly how much your insurance will cover is based on your policy and involves deductibles, copayments, or coinsurance payments for given treatments. Before you make an appointment for an in-person or online psychiatrist, confirm with your insurer what’s covered under your policy.
An estimated 57.8 million Americans received mental health care within the last year, according to the National Institute of Mental Health (NAMI). Yet, navigating the world of health insurance coverage for mental healthcare service can still feel overwhelming and confusing — so if you’ve been wondering does insurance cover psychiatrist visits and care, read on. We’re sharing everything you need to know.
Is Psychiatry Usually Covered by Insurance?
When seeking mental health care, it’s normal to be concerned and question: does health insurance cover psychiatrist visits in every instance?
Rest assured, when it comes to insurance coverage for psychiatry the answer is usually yes. Your health insurance plan will cover some — or even all — of your care. Many health plans provide financial support for psychiatric care, but it’s critical to understand that not all plans are created equal, and there may be restrictions on the types of psychiatrists and mental health services your health plan covers.
Review your policy documents or contact your insurer directly to determine if your insurance company covers a psychiatrist. Today, most insurers have online tools to check which services are covered under your plan and which doctors you can see.
When talking to your insurance company, make sure you get a thorough explanation of what’s included vs. excluded in your policy so that when you receive care, you know exactly what your financial responsibility might be.
“Yes. Psychiatrists can offer therapy, refer patients to psychologists and counselors, and prescribe medication. Please contact your insurance to find out what your specific plan covers.”– Talkspace therapist Famous Erwin, LMHC
What is Covered by Insurance for Psychiatry?
Know that some aspects of psychiatric care are usually more likely to be covered than others. For example, office visits and sessions, medication management, emergency services, and talk therapy services are generally included if you have health insurance coverage, whereas couples counseling often isn’t.
Most health plans cover consultation visits to diagnose and treat mental health conditions. Before making an appointment with a psychiatrist, verify any copayment or coinsurance costs you might be responsible for. Before making an appointment, you should also check with your insurer about constraints or limits on care.
Does insurance cover therapy? Yes, most insurance companies offer coverage for talk therapy sessions that help you work through issues, manage mental health, and improve the overall quality of your life.
Licensed psychiatrists are skilled at diagnosing and treating depression, anxiety, and post-traumatic stress disorder (PTSD). In addition, talk therapy is very effective in helping you learn to manage your symptoms and conditions. Depending on your particular plan, there may be restrictions on the frequency or number of sessions allowed each year.
Insurance can cover the cost of prescription medications used to treat various mental health conditions. Some insurers require a doctor’s approval before covering certain medications, while others might only partially reimburse for specific prescription drug options. Before committing to a treatment plan, check which prescriptions are covered and ask about any caps.
If you experience an acute episode related to a mental health condition — for example, suicidal thoughts or behavior changes due to psychosis — most plans will cover the cost of emergency services provided by psychiatrists or other qualified professionals. Sometimes coverage can even include hospitalization. When possible, it’s always a good idea to check with your healthcare provider beforehand to know exactly what your policy covers.
How to Find Out if Your Insurance Covers a Psychiatrist
Understanding how your insurance policy works is crucial to ensure you receive affordable care.
Verify what mental health coverage your plan offers and if pre-authorization is required. Many plans will cover psychiatric services, but they may require you to get authorization before receiving treatment. They also might only cover treatment from certain “in-network” providers. Make sure to read all the fine print so you know exactly what is and isn’t covered.
- Understand mental health parity laws: Mental health parity laws require that insurers offer the same coverage for mental health services as they do for medical or surgical benefits. These laws necessitate that any limits or constraints on mental health benefits should be equal to those of medical/surgical coverage (e.g., copays, deductibles). If any disparities are noticed between the two forms of coverage, it’s likely a breach of federal law and should be reported immediately.
- Look into online psychiatry and therapy services: Some online providers offer affordable access to qualified psychiatrists and other mental health professionals without you having to worry about insurance reimbursements or other hassles associated with traditional mental health treatment. An online psychiatry session can cost a fraction of conventional sessions.
- Research psychiatrists in-network with your plan: Using a provider who’s in-network can help keep your portion of the cost of a psychiatrist down. Be sure to ask how much (if any) coverage you have if you see out-of-network providers.
Affordable Psychiatric Care With or Without Insurance
Finding affordable psychiatric care doesn’t have to be difficult, regardless of whether or not you have a health insurance plan. Fortunately, there are several avenues you can take to get the care you need without paying a fortune.
Take control of your mental health condition today and get the support you need by signing up with Talkspace’s online therapy service. Talkspace offers online therapy and psychiatry that takes insurance. We provide comprehensive and affordable care that gives you access to quality psychiatrists and therapists without breaking the bank.
- Mental illness. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/mental-illnes. Accessed March 23, 2023.