Getting affordable mental health insurance can be challenging. Those who have a job may receive insurance through their employers. However, most mentally ill persons are unemployed and therefore may be unable to afford the steep insurance premiums. In recent times, government has stepped in to make it easier for the mentally ill to receive adequate insurance benefits. The Mental Health Parity Act, MHPA, of 1996 states that mental health plans must set the same limits as those for medical benefits. However, the Act does not require all health plans to provide mental health benefits.
Private Insurance
Those employed may be covered by their employer under a managed care plan which allows them to visit a doctor chosen by the managed care company. You will be required to pay a copay, but your rate may not be the same as other health care costs. Your employer may also offer an employee assistance plan, EAP, which provides mental health and/or substance abuse screening. Your EAP may not include all services, but your visits are confidential and are not discussed with your employer.
Social Security
If you have a chronic mental illness, and have worked for a certain period of time and paid Social Security taxes, you may be eligible for Social Security Disability Insurance. This pays for some living expenses as well as your health care costs. Most mentally ill patients receive this type of insurance.
Medicare
If you are 65 or old and have paid Social Security taxes, you qualify for Medicare benefits. However, if you are not yet 65 and have a disability, you may still qualify. Medicare has four parts: Part A, which is free, covers your inpatient stay at a hospital or nursing home. It does not cover long-term care. Part B covers outpatient expenses, such as doctors' services and therapy groups. Part C, also known as the Medicare Advantage Plan, is private insurance approved by Medicare. The newest addition is Part D which covers prescription drugs. You pay a supplemental premium for Part B and for prescription drugs. If you are a low-income person, your state may help you pay for Part A and/or Part B. Many mentally ill persons qualify for this kind of help.
Medicaid
Unlike Medicare, which is a federal program, Medicaid is state-run and as such, rules differ from state to state. Medicaid is a program for low-income individuals who are eligible, that is disabled or mentally ill. Depending on your state's rules, you may be required to pay a small copayment for services.
Prescription Drug Coverage
Psychotropic drugs are very expensive and paying for them presents a serious challenge for the mentally ill. Now, under the Medicare Prescription Drug plan, you automatically qualify for extra help to pay for prescription costs if you receive Medicare and Supplemental Security Income or Medicare and Medicaid. If you have Medicare Part A and Part B, you may be eligible under these conditions: your combined savings, investments, real estate--not including the home you live in--do not exceed $25,010, if you are married and living with your spouse. If you are single, the ceiling is $12, 510. If you fall in this category you should apply for Extra Help.
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