The end of the year can be a tough time for people managing mental health conditions, especially during the holiday season. Many people seek higher levels of care around December and January. While these programs can be expensive for individuals to pay for out of pocket, many clinical providers like Lightfully now accept health insurance. If your health insurance coverage rate changes after you’ve met an annual deductible, you could save a lot on treatment through the end of this year.

Thanks to the mental health parity law passed in 2008, most insurance providers are required to cover mental health services to the same extent that they cover medical treatments and procedures. This means fewer limits on therapy sessions and more coverage of intensive treatment programs like Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs). More than 15 years later, many people still aren’t aware that their health insurance may cover these kinds of mental health treatments.

In this blog post, we’ll discuss how to make the most of your insurance benefits to save on mental health treatment costs at the end of the year.

How can I make the most of my insurance benefits to save on mental health treatment costs at the end of the year?

If your plan has a deductible, you’ll need to find out how your costs for mental health treatment change after you meet your deductible. You’ll also need to know how close you are to meeting your deductible and how many weeks of treatment you may need. After January 1, most deductibles will reset to zero. You can save the most on treatment at the end of the year by planning your full course of treatment before your deductible resets. If your plan doesn’t have a deductible, your cost of treatment may be the same at any time of year. However, it’s important to factor in other kinds of financial support, such as disability benefits.

Understand how your insurance works for mental health treatment

Some insurance plans will require people to pay the same copay rate for mental health treatment at any time of the year. Others will require you to pay different amounts of coinsurance depending on whether you’ve met your deductible. Your deductible is the amount of money you pay before your insurance company starts paying for certain covered expenses. For example, you might pay 70% coinsurance until your deductible of $9,000 is met and then pay 30% coinsurance for any treatment after that point.

Your insurance carrier should provide you with a coverage breakdown that explains how your plan works for different types of treatment. Certain types of care that can be considered preventive, like outpatient therapy and medications, may be covered at the same rate all year. More intensive forms of treatment like PHP and IOP are more likely to change based on your status with your deductible.

Find out what details will affect your mental health treatment options and costs

The amount that you’ve already paid toward your annual deductible may affect your mental health treatment costs through the end of the year, depending on how your plan works. You should be able to check where you are with your deductible if your insurance provider has an online portal. Otherwise, you can check with your representative. If you’ve already met your deductible, your coinsurance rate is likely to be lower. If you’re very close to meeting your deductible, you may only have to pay a higher rate until your deductible is met.

The next step is to find mental health care providers that accept your insurance. Consider what level of treatment you may need and whether your insurance company requires a referral from your primary care doctor. You may need to check with your insurance company to verify that a certain care provider is covered. Take a look at our Admissions page for information about the insurance plans we accept.

Next, you’ll need a quote for treatment cost per week so you can estimate your coinsurance amount before and after you’ve met your deductible. Contact our Admissions Concierge Team for estimates of how much your treatment may cost per week.

Prioritize your mental health care needs

Unfortunately, the limitations of insurance plans can make treatment decisions difficult. If you’re not close to meeting your deductible, you may face high out-of-pocket costs. Many people also depend on short-term disability benefits to cover their cost of living during treatment. As the name implies, these benefits are time bound. While these realities may affect your treatment options, it’s important to keep your mental health care needs in perspective while you look for solutions.

Getting treatment now may make a big difference in your ability to work and earn an income over the next year. It can improve your quality of life, too. Remember that your deductible will reset at the beginning of next year. Get a clear idea of all the costs involved and how long your treatment may take so you can plan ahead to cover the cost of your entire treatment without too much of a delay. Even if your costs are only lowered for a part of your treatment, it may be better to do it now than to wait until next year.

Remember that you’re not in this alone. Your assessment team, admissions counselors, case manager and other representatives at your workplace and insurance company can help you through the process. See if you have access to a health care advocate who can help you negotiate costs. Ask care providers about financing options.

Explore insurance-covered treatment options at Lightfully

Navigating your insurance plan and making care decisions when you’re seeking treatment is challenging, to say the least. We’re here to support you every step of the way. Because we work with a high volume of clients at Lightfully, we’re able to accept most major insurance carriers and some smaller plans. We provide four different levels of treatment and a Short-Term Option to help make your treatment work with your schedule.

Are you ready to start exploring your treatment options? You’ll need to schedule an assessment to find out the details of your individualized treatment plan. For general questions and assessment scheduling, you can reach out to our Admissions Concierge Team.

Let’s make a plan so you can get the treatment you need at a price you can afford. Contact us to start the conversation today.