How to Use Your Health Insurance for Mental Health Care

Understand mental health insurance coverage, costs and treatment options. Find providers and access care with or without insurance in 2026.

Written by Erin C. Perkins

Updated: January 12, 2026

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Mental health shapes how people think, feel, handle stress, interact with others and make decisions. But many people who want help struggle to get it because of confusing insurance rules, limited provider networks and high out-of-pocket costs.

About one in four U.S. adults (23.4%, or roughly 61.5 million people) experienced a mental illness in 2024. Demand for mental health services continues to climb. Medical claims for mental health treatment have increased 83% since 2019.

This article explains how health insurance covers mental health care, compares in-person and virtual options and identifies support for uninsured people or those having trouble accessing treatment.

A CLOSER LOOK AT THE IMPACT OF MENTAL ILLNESS

These statistics show the scope and barriers:

About one in four U.S. adults (23.4%) experienced a mental illness in 2024, and 5.6% experienced a serious mental illness
Among adolescents ages 12 to 17, 15.4% had at least one major depressive episode in the past year. Families report trouble finding in-network child and adolescent mental health providers even when they have insurance. Our research on youth mental health by state shows where families can find better access to child and adolescent providers.
About half of adults with any mental illness receive treatment. Many report cost, lack of in-network providers or long wait times as barriers to care. Young adults ages 18 to 25 have especially low treatment rates. Finding affordable health insurance as a young adult can help improve access to mental health care.
Mental health-related medical claims have increased 83% since 2019, showing how rapidly demand for services has grown
Research estimates show an average delay of 11 years between symptom onset and first treatment
Access to mental health care varies widely by location. Our analysis of the best states for mental health services shows how state policies and provider availability impact treatment access.

Finding the Right Mental Health Care

Choose a licensed mental health care provider who understands your insurance benefits. Federal mental health parity law requires most group and individual health plans to cover mental health and substance use disorder services on terms comparable to medical and surgical care.

Choosing the Right Mental Health Professionals

Choosing the right mental health provider improves treatment outcomes.

1
Determine what you need
Start with a physician for a physical exam to rule out other conditions with symptoms similar to mental illness.
2
Talk to your health insurance provider
If you have insurance, call your provider to learn what your plan covers for mental health care. Most insurance plans cover therapeutic services. Start with your insurer's network of mental health providers. Note if they have a subspecialty relevant to your needs, such as depression or bipolar disorder, and their treatment approaches.
3
No insurance? Get recommendations
Check with the psychiatry or psychology department at a local university for provider recommendations. Call a large clinic for recommendations. And don't be shy about checking with friends and family.
4
Make an appointment
If it'll be a while before a mental health specialist can see you, ask to join the waiting list for cancellations. Need help sooner? Check if your primary care doctor can provide treatment and support. If it's an emergency, go to a hospital emergency room or contact the 988 Suicide & Crisis Lifeline (call or text 988, or chat at 988lifeline.org).
5
Ask plenty of questions
In your first session, evaluate whether the mental health professional fits your long-term goals and needs. Here are some questions to consider asking:
- How long have you been in practice?
- Have you treated patients with similar issues, and what were the results?
- How will you work with me and evaluate my progress?
- What are your policies and fees? If concerned about the amount, ask about sliding scale or discounted payment options.
If cultural considerations are important, ask if the therapist is familiar with your community:
- Do you have experience treating others from my cultural background?
- If not, are you willing to learn about my cultural background and respect my perspective?

Treatments Health Insurance Can Cover

Mental and behavioral health services are essential benefits in many health plans. Most large group, individual and public plans must follow mental health parity rules. Your plan cannot impose more restrictive copays, visit limits or prior authorization rules on covered mental health and substance use disorder services than it does on comparable medical services.

Specific mental and behavioral health benefits depend on your state and health plan. Common covered treatments include:

Psychotherapy and counseling: Also known as "talk therapy," this helps patients cope with daily life, trauma, grief or specific mental disorders like depression or anxiety.
Psychiatric emergency services: This may include attempted suicide, substance abuse, depression, psychosis, violence or other sudden changes in behavior that result in needing urgent attention.
Telehealth and online therapy: Virtual visits by video or phone let you see a therapist or prescriber from home. Many plans cover telehealth mental health visits similarly to in-person care, though coverage rules, copays and provider network requirements differ by plan. Check with your insurer about virtual visit coverage, whether providers must be in-network and copay differences.
Addiction treatment: Helps people with substance abuse stop compulsive drug seeking and use. Treatment includes cognitive-behavioral therapy, medications or both.
Co-occurring medical and behavioral health conditions: Treatment for dual diagnoses such as coexisting addiction and depression.

Paying for Mental Health Care Using Insurance

Cost is one of the biggest barriers to mental health treatment. Unlike Medicare, which the government funds and sets pricing, private insurance costs vary because each insurer negotiates pricing with health care providers.

Current Therapy and Psychiatry Costs

Individual therapy sessions range from $100 to $250 per session. Many private-pay rates fall between $120 and $200, depending on the provider's credentials, location and specialty. Your actual out-of-pocket cost is usually much lower if you see an in-network therapist and pay only your plan's copay or coinsurance amount.

If you need to see a psychiatrist for medication or an evaluation, you'll pay additional costs. Prices vary widely by drug. For example, fluoxetine (the generic form of Prozac) costs a few dollars per month at some pharmacies with discounts, while brand-name versions cost much more. Using a pharmacy discount program or comparing prices at different pharmacies lowers your costs.

PRESCRIPTION DISCOUNT PROGRAMS REDUCE MEDICATION COSTS

Tools like GoodRx and similar prescription discount programs let you compare cash prices at nearby pharmacies and apply coupons, which can reduce what you pay if you're uninsured or your plan has a high deductible.

Medication-management follow-up visits with a psychiatrist last 15 to 30 minutes and cost $100 to $250 before insurance, though prices vary by practice and location. If your psychiatrist is in-network, your plan charges only a specialist copay or coinsurance. Confirming their network status and your mental health copay before your first visit helps you budget.

The best health insurance policies make receiving and paying for mental health services more manageable. People with coverage pay less. For people without coverage or with high deductibles, paying for mental health care remains stressful, but options like community clinics, sliding-scale providers, virtual therapy platforms and prescription discount tools help lower costs.

Understanding Your Mental Health Insurance Coverage

Many people struggle to understand health insurance while managing mental health symptoms. Learn basic insurance terms, review your mental health benefits and calculate potential costs to make your coverage predictable.

1
Understand common insurance terms
Learn these basic health insurance terms to understand your mental health benefits:
- Deductible: What you pay out of pocket before your insurance covers costs.
- Copay: A fixed amount you pay for each health care visit or service.
- In-network: Health care providers (physicians, hospitals, clinics) who accept your insurance.
- Out-of-pocket maximum (OOP max): The most you pay yearly for covered services before your insurance covers 100%.
Understanding how deductibles and out-of-pocket maximums work together and the difference between copays and coinsurance helps you budget for mental health care.
2
Get a clear understanding of your coverage
Review your schedule of benefits, which outlines costs for all health care services your plan covers. Call your insurance company with specific questions about your coverage, costs for out-of-network providers and visit limits.

Ask these questions about mental health and substance use coverage:
- "Do you cover virtual (telehealth) therapy and psychiatry visits? Are they billed the same as in-person visits?"
- "Is there a limit on covered mental health visits per year? What happens if my provider says I need more?"
- "Do I need prior authorization for therapy, intensive outpatient programs or residential treatment?"
- "What should I do if no in-network therapists or psychiatrists near me accept new patients?"
3
Nail down the cost
Calculate your expected out-of-pocket costs before starting treatment. Estimate how many therapy sessions and psychiatric appointments you'll need yearly, plus any prescription costs. Add your insurance premium to determine your total annual cost for mental health care.
4
File a claim correctly
Your health care provider typically files claims and bills you for costs your insurance doesn't cover. If you need to submit your own claim, request an itemized bill from your provider that includes the visit reason, service date and your policy number. Complete the claim form, review it before submitting and keep copies for your records.

Choosing the Right Health Insurance

Three key factors to consider when choosing health insurance:

Coverage level: If you're buying from the health care marketplace, choose from four categories: Bronze (insurance covers 60%), Silver (insurance covers 70%), Gold (insurance covers 80%) and Platinum (insurance covers 90%).

Total costs: It's easy to focus on your monthly premiums. But for a more accurate picture, consider total costs, including your monthly premium, deductible and potential out-of-pocket costs. Consider the entire cost when shopping for a plan.

Plan and network types: Know the plan and network types: HMO vs. PPO, PO and EPO. Based on your plan type, you can use almost any mental health provider or face limits and higher costs for out-of-network providers.

Common Health Insurance Questions Answered

Most people have questions about how insurance covers mental health care and what to do when coverage falls short.

If I don’t have health insurance, how does that affect my access to mental health services?

People without insurance have less access to mental health care than insured people. In national surveys, about half of adults with any mental illness receive treatment in a given year. Uninsured adults are far less likely to get care than those with coverage. Lack of insurance and high out-of-pocket costs are reasons for delaying or skipping needed mental health care, which worsens symptoms and other health conditions over time.

Why is medical coverage for mental health issues complicated?

Mental health coverage feels complicated because of how insurance plans are structured and how mental health services differ from other medical care. Federal parity law requires most plans to cover mental health and substance use disorder services comparably to medical services, but practical application varies widely. Plans have different networks of mental health providers, varying prior authorization requirements and different copays for in-network versus out-of-network care. Provider shortages in many areas add complexity. Finding an in-network therapist or psychiatrist accepting new patients is difficult in many areas.

How do I choose the right mental health professional?

Start by checking if the provider is in your insurance network and accepting new patients. Ask about their experience treating your concern (anxiety, depression, trauma, etc.) and their treatment approach. Consider practical factors like location, appointment availability and telehealth options. During your first session, pay attention to whether you feel comfortable and understood. The therapeutic relationship matters as much as credentials. Don't hesitate to try a different provider if the first one isn't a good fit.

What You Can Do if the Insurance Won’t Pay

Health plans deny all or part of a claim for reasons such as missing information, coding or billing errors, questions about medical necessity or because a service is not covered. You have the right to ask for a clear explanation and to appeal the denial. The Affordable Care Act and federal parity law give most people in private health plans the right to an internal appeal and, in many cases, an external review by an independent reviewer.

1
Check whether the denial might violate mental health parity rules
Parity rules say your plan cannot make it harder to get covered mental health or substance use disorder treatment than comparable medical care. For example, it cannot use stricter prior authorization rules, tighter visit limits or narrower networks. If you suspect the denial reflects unequal treatment of mental health services, save all documents and ask your plan to explain how its rules for your mental health benefit compare with those for similar medical and surgical services.

Important context on parity enforcement: In May 2025, federal agencies paused enforcement of strengthened 2024 parity regulations while litigation proceeds, but the underlying Mental Health Parity and Addiction Equity Act (MHPAEA) statute and earlier 2013 regulations remain in full effect. Many state insurance departments enforce parity protections actively. You still have the right to challenge denials that treat mental health services less favorably than medical services. You can file complaints with your state insurance department or the U.S. Department of Labor (for employer plans) during the federal enforcement pause.
2
Contact the insurance company to ask for a thorough explanation of the denial
Ask your insurer to clarify why the claim was denied and what documentation would support approval. You can also ask your HR benefits representative or insurance agent to help you understand claims, appeals and benefits or to contact the insurance company for you.
3
Contact your state’s insurance division
If you complete the insurance company's internal appeals process and aren't satisfied, your state's insurance division can help.
4
Do you have a self-insured plan?
You can enlist the help of a benefits advisor in a regional office of the U.S. Department of Labor (DOL) who can enforce parity.

An illustration of two women hugging each other.

Getting Affordable Mental Health Care Without Insurance

Concern about paying for mental health care is common. Many people need help and worry they can't afford it. A 2024 national survey found that tens of millions of adults experienced a mental illness in the past year and reported unmet needs for care. Though some insurance companies don't provide much mental health coverage and have expensive copays and deductibles, affordable and free mental health care options exist. If you don't have coverage, learn how to get health insurance through the marketplace or other programs.

Government Support for Mental Health

The federal government has options and resources for people seeking mental health support. It regulates systems and providers, protects consumers' rights, provides major funding for services and supports research. It establishes and sets standards that states can build on.

Medicare: Covers multiple treatment services for people with mental illness and substance abuse disorders, including psychological counseling, preventive screenings and outpatient treatment programs. Special rules limit coverage. Get started by letting your doctor's office know you want to schedule your "Welcome to Medicare" preventive visit.

Important 2025 Medicare mental health updates:

$2,000 annual out-of-pocket cap on Part D prescription drugs took effect in 2025, reducing costs for many people taking psychiatric medications
Medicare now covers services from Licensed Mental Health Counselors (LMHCs) and Marriage and Family Therapists (MFTs), expanding provider options beyond psychiatrists and psychologists

Medicaid: Care under Medicaid varies by state and county but generally covers counseling services, therapy, medication management, social work services and substance abuse treatment. Contact your state to determine if you qualify.

Affordability note: Recent federal legislation reduced Medicaid funding, and enhanced marketplace subsidies that lowered premiums in the early 2020s expired December 31, 2025. These changes may affect coverage availability and costs. If you currently have or are considering Medicaid or marketplace coverage, re-check your eligibility and compare plan costs during each open enrollment period, as your options and premiums may have changed significantly.

If you're unsure which program you qualify for, learn about the differences between Medicare and Medicaid.

Social Security Disability Insurance Benefits (SSDI) and Supplemental Security Income (SSI): Certain mental disorders qualify you to receive monthly benefits from SSI or SSDI. Each requires that your impairment prevents you from working. Children with an impairment can also receive SSI benefits. Regardless of the type of mental disorder, you must show that you're receiving and complying with treatment.

Substance Abuse and Mental Health Services Administration (SAMHSA): Works to improve substance abuse and mental health treatment services. As of March 2025, SAMHSA was consolidated into HHS's new Administration for a Healthy America (AHA), a consolidated HHS agency overseeing behavioral health programs. Key resources continue to operate: The Behavioral Health Treatment Services Locator at FindTreatment.gov, The National Helpline for mental or substance use disorders (1-800-662-HELP), and The 988 Suicide & Crisis Lifeline.

U.S. Department of Veterans Affairs Mental Health Resources: Provides an array of information about mental health and support services, both locally and nationally, specifically for veterans, including Treatment Works For Vets and the National Center for PTSD.

Employee Assistance Programs

Employee Assistance Programs (EAPs) are work-based programs that offer confidential, free support to employees struggling with mental health issues, substance abuse and grief. Most EAPs provide a limited number of free counseling sessions per issue (usually 3 to 6, sometimes more) along with 24/7 phone access to counselors and referrals for longer-term care. Most EAPs don't offer long-term counseling but refer employees to services for long-term solutions. Check your employee benefits or ask your HR benefits department.

Free Clinics and Nonprofit Options

Free clinics and nonprofits provide support options.

Contact local facilities to learn if they offer the free mental health services you need.
The National Association of Free and Charitable Clinics has a search tool for finding health services clinics.
Contact a university training clinic near you. Many have free or low-cost therapy options. The Association of Psychology Training Clinics has listings.
The 988 Suicide & Crisis Lifeline provides recommendations for nearby mental health services.

Virtual Therapy

Over the past several years, online and virtual therapy have become a mainstream way to receive mental health care, not just a temporary option during the COVID-19 emergency. Research and professional organizations report that, for many conditions, online cognitive behavioral therapy and other structured treatments are as effective as in-person therapy. Virtual care helps people who have transportation, scheduling or mobility barriers.

Before signing up for any virtual therapy platform, check whether it accepts your insurance plan, whether its providers are in your network or whether it provides documentation you can use to submit out-of-network claims. Coverage and reimbursement vary widely by insurer and plan type.

Insurance coverage varies by platform and plan. Options to consider:

MDLive: Providers available via phone and video for mental health consultations. Check with your insurance to see if MDLive is covered.

Teladoc: Virtual care appointments available seven days a week with flexible scheduling. Many health plans include Teladoc coverage.

Talkspace: Offers therapy for individuals, couples and teens. Talkspace accepts major insurance plans, including Aetna, Cigna, Optum/UnitedHealthcare and Blue Cross Blue Shield plans. Typical copays are $30 or less when using in-network benefits, depending on your policy.

BetterHelp: Large network of therapists available for online sessions. BetterHelp is adding insurance partnerships and accepts insurance in some states through select major carriers. Coverage and copays vary, so you'll need to go through BetterHelp's sign-up flow to see if your plan is eligible. Many people can also use HSA or FSA funds for payment.

Pride Counseling: Specializes in therapy for the LGBTQ+ community with therapists experienced in LGBTQ+ issues.

An illustration of a young woman meditating.

Ways to Practice Self-Care at Home

Taking care of yourself benefits your mental health and quality of life. Self-care supports your treatment if you're dealing with mental health issues. It's not a replacement for professional care, but even small acts of self-care incorporated into your daily life help manage stress, lower your risk of illness and boost your mood.

Exercise regularly. Physical activity produces stress-relieving hormones and improves your overall health.
Eat well. Whole grains, vegetables and fresh fruit lower your risk for chronic diseases and boost your energy and mood.
Get enough sleep. Aim for seven to nine hours nightly. Practice good sleep hygiene by avoiding computers and digital devices before bed.
Practice deep breathing and meditation. These techniques reduce stress quickly and help you process conflicts and problems. Try apps like Simple Habit and Headspace for guided meditations.
Set aside time for yourself. Even five minutes daily reminds you that you matter.
Recognize the positive. Write down one positive thing each day or week to shift your perspective. Apps like Happify and Moodfit offer therapeutic tools including gratitude journals.

Resources for Mental Health Care

Most people experience mental health issues at some point in life. Getting help by seeking professional care is OK. Resources, groups and programs are available to assist you, whether you need a short-term or long-term solution.

Organizations to get you started:

988 Suicide & Crisis Lifeline: For urgent help with suicidal thoughts, a mental health or substance use crisis, or emotional distress, call or text 988, or chat at 988lifeline.org. Support is free, confidential and available 24/7. Note: The "press 3" option that previously connected LGBTQ+ youth to specialized counselors through the 988 system ended July 17, 2025. However, The Trevor Project (see below) continues to provide dedicated 24/7 crisis services for LGBTQ+ young people through its own phone, text and chat services.

Crisis Text Line: Text HOME to 741741 to connect with a crisis counselor for free, confidential support 24/7.

FindTreatment.gov: Find a provider treating substance use disorders, addiction and mental illness.

SAMHSA's National Helpline: Call 1-800-662-HELP (4357) for free, confidential, 24/7 treatment referral and information service for individuals and families facing mental health or substance use disorders.

National Council on Alcoholism and Drug Dependence: This advocacy group provides information on local resources for getting help for substance abuse, along with support for friends and family members.

The Trevor Project: This nonprofit provides 24/7 crisis support specifically for LGBTQ+ young people. Call 1-866-488-7386, text START to 678-678, or chat at TheTrevorProject.org for free, confidential counseling on issues including coming out, LGBTQ identity, depression and suicide. The Trevor Project continues to operate independently after its connection to the 988 system ended in July 2025.

American Psychiatric Association Foundation: Promotes high-quality care for individuals with mental illness, including substance use disorders. Provides a search tool for finding psychiatrists.

American Academy of Child and Adolescent Psychiatry: Offers an online research tool to help parents find psychiatric care for their children.

Make the Connection: Raises awareness about mental health symptoms, conditions and treatment for veterans. Includes a search tool to find local support.

National Empowerment Center: Provides information and advocacy resources for people diagnosed with mental illness.

National Alliance on Mental Illness (NAMI): This nonprofit provides resources on mental disorders that are helpful for people who have experienced mental illness and their families, including support groups, education and training. NAMI HelpLine: 1-800-950-NAMI (6264) or text "NAMI" to 62640.

Freedom From Fear: This nonprofit provides information, screening tools and other resources on many types of anxiety disorders.

Mental Health America: This organization promotes prevention, diagnosis and treatment for people at risk of mental illness.

Soaring Spirits International: This group offers peer-based support programs to people coping with grief.

Dual Recovery Anonymous: This group conducts meetings for people who have both substance addiction and a mental illness.

Many of these organizations can also help you understand options if you have limited or no insurance and can connect you to local providers or crisis services.

About Erin C. Perkins

Erin C. Perkins is a finance writer at MoneyGeek, with 15 years of experience in the media industry. She has covered topics about money, including banking, insurance and budgeting for several publications over the years.

Perkins has a master's degree in magazine journalism from Kent State University and a bachelor's degree in mass communications from Winston-Salem State University.

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