Mental health insurance coverage is a must for modern employers
The prevalence of depression and anxiety in adults has skyrocketed since the start of the covid-19 pandemic, according to the most recent study by Mental Health America. Mental illness can affect anyone, regardless of their background, age, status, job role, or other personal factors. Whether you know it or not, you have employees that are currently experiencing mental health struggles.
Employers should create an environment where employees can do their best work and feel good about their contributions. Part of creating that positive working environment involves providing employees with health coverage to address any mental health or substance use concerns they are experiencing.
It’s important to make these considerations well in advance, so adjustments to health insurance coverages can be made. Then, you can make changes to ensure your insurance includes appropriate coverage for mental health if needed.
Are mental health services covered by health insurance?
Most health insurance plans do cover mental health and behavioral health services. However, it’s never a bad idea to double-check the coverage details.
The 2008 Mental Health Parity and Addiction Equity Act was passed in order to push insurers to treat mental health treatment the same as treatment for physical health problems. It requires that insurance companies avoid imposing additional limitations on mental health or addiction services that are less favorable than the limitations placed on other health services. For example, an insurer can no longer place a limit on the number of covered counseling sessions, if sessions for other health concerns are not limited. Copayments for mental health services should also be similar to the copayments for other specialist services, including inpatient services.
All health plans offered on the government health insurance marketplace, which can be accessed at healthcare.gov, cover mental health conditions as an essential health benefit per the Affordable Care Act (ACA). The ACA also prevents insurance companies from denying coverage for pre-existing conditions and requires that they cover preventative services. Most employer-sponsored health plans are ACA-compliant and will cover mental health treatment.
However, there can be other barriers to accessing mental health care through employer-sponsored insurance plans such as:
Long wait times for intake appointments.
A lack of in-network providers in the employee’s region.
Being unable to take time off from work for appointments.
High copayments on appointments.
High deductibles making hospitalization or inpatient care inaccessible.
Take a look at the group plans you plan to offer as well as any additional prescription drug benefits to ensure that cost will not be a preventative to accessing care. Training managers and human resources staff to be flexible with time off and sensitive towards those needing time off to access mental health or substance use disorder services can also help.
Why is providing access to mental health coverage important?
After a hectic year and a half with frequent work and life changes due to the pandemic, employees are more susceptible to burnout or other mental health struggles than ever.
Employees who are struggling with their mental health are likely to be less focused and less engaged with their work and their peers. This can cause their work performance to decline. As a business owner or manager, you want your employees to be able to meet productivity, work quality, and customer service expectations. Most employees want to meet those expectations as well, but sometimes they need additional help to ensure that they are in the right headspace to fulfill their work and personal obligations. This is where psychotherapy, medication, outpatient services, and other mental health treatments come in.
Unhappy employees can also negatively impact the overall culture of your company. When a small group of employees is unhappy, that can spread and cause other employees to become disengaged. Of course, mental illness isn’t contagious like the flu, but untreated illnesses like depression or anxiety can lead to a lack of engagement or negative feelings about the company. Showing that you care about your staff through your benefits offerings also promotes a positive culture. Investing in better health insurance with mental health coverage for your employees is an investment in your staff and your organizational culture.
It’s important from a business perspective, and also from a human perspective. Accessing mental health care can be challenging due to the stigma associated with mental illness and substance abuse, so do your best to avoid letting insurance coverage become another barrier to treatment for your employees.
How can you ensure that employees have access to mental health care?
You want your employees to be able to easily access care. When evaluating care, here are some considerations to keep in mind.
Review healthcare coverage documents
Take a look at the health plans that you are currently offering. Are mental health services covered by all of them? Are there enough in-network behavioral healthcare providers covered by the offered plans in your area? Are you offering at least one plan with reasonably affordable copays?
Many employers offer plans with low monthly premiums but high deductibles and copayments, these are great for employees who do not use healthcare services frequently. However, employees seeking services such as weekly therapy sessions, regular psychiatrist visits, and ongoing medication tend to be better served by plans with lower copays and slightly higher premiums. You want to provide employees with plans that they can actually afford to use. Pay special attention to deductibles, inpatient treatment costs, and mental health services appointment copays.
HMO vs PPO
When it comes to deciding between HMO and PPO plans, there’s no overarching correct answer on which is better for the insured as both come with benefits and drawbacks. If your business operates in a region where HMO health systems are popular, you will probably have employees that would like to have the option to enroll in an HMO. You should try to avoid offering an HMO as the only option though.
Ideally, employees will be able to choose between several insurance plans and providers to select a plan that best meets their needs. However, small businesses often start out only offering one option. If you need to stick to one plan or insurance provider, choose a PPO. PPO insurance provides more flexibility in choosing healthcare providers and referrals are typically not required to see mental health providers. This is important for those looking to receive mental health services because mental health treatment is most successful when the patient is able to find a therapist, psychiatrist, and/or facility that they feel comfortable with. Some large HMO healthcare systems have faced scrutiny in recent years for their mental health service quality, and this is somewhat to be expected as one system, and their set of treatment practices, can’t meet everyone’s unique needs in an area as personal and complex as mental health.
Employee assistance plans
Employee assistance plans (EAPs) have been rising in popularity as a way to provide assistance to employees, including support for mental health treatment and substance use recovery. EAPs help employees access professional support for mental health support, addiction recovery, legal assistance, and directories for finding child and eldercare services. EAPs often cover a limited number of free counseling sessions for employees. These plans are a great way to provide added support, but are not a substitute for proper mental health coverage in your employer-sponsored health insurance plans.
Encouraging employee mental wellness
Providing adequate mental health insurance coverage is one of the most important steps that you can take as an employer to promote employee wellness in your workplace. Employees that need support should be encouraged to seek care from mental health professionals, and you should provide a workplace that is also accepting and supportive. Offering flexible leave and time off options, EAPs, and a culture of open communication can also help employees access mental health care.
Be mindful of employee burnout and stress as well to support employees during this time of heightened anxiety. Ensure that everyone takes breaks, uses their time off balances, and is not working excessive overtime. Check in with employees during high-pressure busy seasons or periods of change (including the transition back to the office!) to promote workplace wellness and mental health.