Gone are the days in which mental health care was not treated with the same level of importance as care for physical health issues. These days, both the Affordable Care Act and California law set forth minimum standards for health care plans and providers, so that those needing treatment can seek and receive the services they require.
But as with anything else, knowing your rights is the key to accessing them. So here is what you need to know about mental health care and the law.
Under the ACA, mental health services are deemed “essential”, meaning any plan that seeks to be ACA-compliant must provide a certain level of care in this area of health. Services that must be provided under the plan include:
- Treatments such as counseling and psychotherapy
- Inpatient mental and behavioral health services
- Substance abuse treatment
These mental health services are subject to the same standards as medical and surgical care in how care is managed and how deductibles and co-pays are applied.
Additionally, California law supplements ACA requirements by specifying a number of specific conditions for which care must be provided:
- Major depressive disorders
- Autism or pervasive developmental disorder
- Bipolar disorder
- Panic disorder
- Schizophrenia
- Schizoaffective disorder
- Obsessive-compulsive disorder
- Anorexia nervosa
- Bulimia nervosa
- Serious emotional disturbances in children under age 18
California healthcare plans must cover inpatient and outpatient treatment, as directed by the overseeing doctor, and prescription drugs when needed.
Your health insurance plan, however, could stipulate how you access mental health services, so contact your insurance company or broker to learn how to access this benefit.
Finally, if you seek an initial consultation for mental health care, California law requires that the provider or facility provide you with a return appointment within 10 days. The same deadline applies to referrals for mental health care from your primary care provider.
We are fortunate that the law does take mental health seriously, and that we can all obtain care when we need it. Just as with any other healthcare need, seek services promptly when you need them to protect your health. And if you’re ever in doubt as to how your healthcare plan works, or what type of treatment it covers, contact your plan provider’s customer service team.