How
to Pay For Mental Health Services
The
high price of health care can make treatment out of reach for
many people. Those who do not have health insurance-more than
38 million Americans-often avoid treatment entirely because costs
can be staggering.
The
cost of mental health services is a financial challenge for just
about everyone. This fact sheet discusses ways to pay for care
and suggests resources for people who need more information.
For
people experiencing mental health problems-such as anxiety or
depression-brief yet effective treatment options exist. For people
with severe mental illness, treatment is also effective, although
it may take longer and cost more. In either case, treatment works
for most people and helps many recover and get on with their lives.
PRIVATE
INSURANCE
The
majority of working Americans are covered under employer-provided
health insurance plans. One type of plan is a standard indemnity
policy: people are free to visit health care providers of their
choice and pay out-of-pocket for their treatment. The insurance
plan reimburses members for some portion of the cost. The other
common plan is a managed care plan. Medically necessary care is
provided in the most cost-effective-or least expensive-method
available. Plan members must visit health care providers chosen
by the managed care plan. Sometimes a copayment is charged to
the patient, but generally all care received from providers within
the plan is covered. Recently, managed care companies have begun
to provide services in many States for low income Medicare and
Medicaid beneficiaries.
Both
types of health coverage may offer some coverage for mental health
treatment. However, this treatment often is not paid for at the
same rate as other health care costs, or there may be limits on
visits. A few States have enacted "parity" laws that
require insurers to pay for mental health and other health care
costs at the same rate.
If
you are not insured, or if your income is limited, you might try
other strategies to pay for mental health care. Some providers,
for example, have sliding-scale fees. Based on your income-and
your spouse's, if applicable-the provider will reduce his or her
fees. Other providers, if they are aware of your financial limitations,
may be willing to negotiate a payment plan that you can afford
or to lower their rates according to what your insurance plan
pays. The latter is called a "write-off."
Community-Based
Resources. Many communities have community mental health centers
(CMHCs). These centers offer a range of mental health treatment
and counseling services, usually at a reduced rate for low-income
people. CMHCs generally require that you have a private insurance
plan or be a recipient of public assistance.
Your
church or synagogue can put you in touch with a pastoral counseling
program. Certified pastoral counselors, who are ministers in a
recognized religious body, have advanced degrees in pastoral counseling,
as well as professional counseling experience. Pastoral counseling
is often provided on a sliding-scale fee.
Self-Help
Groups. Another option is to join a self-help or support group.
Such groups give people a chance to learn more, and talk about
and work on their common problems-such as alcoholism, substance
abuse, depression, family issues, and relationships. Self-help
groups are generally free and can be found in virtually every
community in America. They have proven to be very effective.
Public
Assistance
People
with severe mental illness may be eligible for several forms of
public assistance, both to meet basic costs of living and to pay
for health care. Such programs include Social Security, Medicare,
Medicaid, and disability benefits.
Medicare
is America's major Federal health insurance program for people
who are 65 or older and for some with disabilities who are under
65. It provides basic protection for the cost of health care.
Two programs can help people who have low incomes receive benefits.
These are the Qualified Medicare Beneficiary (QMB) and the Specified
Low-Income Medicare Beneficiary (SLMB) programs.
Medicaid
pays for some health care costs for America's poorest and most
vulnerable people. More information about Medicaid and who is
eligible for it is available at local welfare and medical assistance
offices. Although there are certain Federal requirements, each
State has its own rules and regulations for Medicaid.
RESOURCES
For more information about paying for mental health care, contact:
National
Mental Health Services
Knowledge Exchange Network
P.O. Box 42490
Washington, DC 20015
Telephone: 800-789-2647
TDD: 301-443-9006
E-mail: ken@mentalhealth.org
www.mentalhealth.org
American
Association of Pastoral Counselors
9504-A Lee Highway
Fairfax, VA 22031-2303
Telephone: 703-385-6967
Fax: 703-352-7725
E-mail: info@aapc.org
www.aapc.org
American
Self-Help Clearinghouse
Saint Clares Hospital
100 E. Hanover Avenue
Cedar Knolls, NJ 07927
Telephone: 973-326-8853
Fax: 973-326-9467
E-mail: njshc@cybernex.net
www.mentalhelp.net/selfhelp
National
Alliance for the Mentally Ill
Colonial Place Three
2107 Wilson Boulevard, Suite 300
Arlington, VA 22201-3042
Telephone: 800-950-6264
Fax: 703-524-9094
www.nami.org
National
Empowerment Center
599 Canal Street
Lawrence, MA 01840
Telephone: 800-769-3728
Fax: 978-681-6426
www.power2u.org
National
Mental Health Consumers Self-Help Clearinghouse
1211 Chestnut Street, Suite 1207
Philadelphia, PA 19107
Telephone: 800-553-4539
Fax: 215-636-6312
E-mail: info@mhselfhelp.org
www.mhselfhelp.org
For
information about Social Security, Medicare, and disability benefits,
call the Social Security Administration at 800-772-1213.
For
information about Medicaid, contact your local social service
or welfare office. You can also get information about Medicare
and Medicaid at www.hcfa.gov
For
information about Community Mental Health Centers, contact:
National Council for Community Behavioral Health Care
12300 Twinbrook Parkway, Suite 320
Rockville, MD 20852
Telephone: 301-984-6200
Fax: 301-881-7159
www.nccbh.org
Note:
These are suggested resources. It is not meant to be a complete
list.
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