TDCI, TDMHSAS Raise Awareness of Insurance Coverage for Mental Health Services During Mental Health Awareness Month

Thursday, April 28, 2022 | 01:58pm

NASHVILLE – The Tennessee Department of Commerce & Insurance (“TDCI”) joins the Tennessee Department of Mental Health and Substance Abuse Services (“TDMHSAS”) to remind Tennesseans that May is recognized as Mental Health Awareness Month, a time to reflect and support individuals who suffer from mental health illnesses.  

As is the case with many physical illnesses, medical treatment for mental illnesses can be costly. TDCI encourages Tennesseans and their loved ones who suffer from a mental health illness to understand how insurance may help cover the cost of treatment. Under the Mental Health Parity and Addiction Equity Act of 2008, any health insurance plan that covers mental health treatment must match its coverage with the plan’s physical health coverage. This applies to copays, deductibles, the number of days covered for a hospital stay, prior authorization, prescription drug tiers, and maximum benefit limits. 

“It is just as vital to care for a person’s emotional, psychological, and mental well-being as it is to care for a person’s physical well-being,” said TDCI Commissioner Carter Lawrence. “We’re grateful for the opportunity to work with our colleagues at the Tennessee Department of Mental Health and Substance Abuse Services to help raise awareness of this important issue.” 

“There’s no difference between diabetes or high blood pressure or mental illness. They are all long-term illnesses that can be managed with the help of medical professionals,” said TDMHSAS Commissioner Marie Williams, LCSW. “With our partners at TDCI, we’re excited to work toward a future where all Tennesseans easily access the mental health services they need.” 

What you need to know about mental health coverage 

  • Contact your health insurance company to learn if your policy covers mental health and substance abuse treatment. 
  • If your plan does, then the mental health treatment limitations must be equal to physical health services. For example, if your copay is $30 for physical health services, it must be $30 for mental health services. If your plan covers 40 physical therapy visits, your plan must cover 40 behavioral health visits. 
  • Treatment for these services may include therapy, behavioral counseling, in-patient and out-patient treatment, and medication management. 
  • Your health plan should provide a directory of in-network professionals and facilities that are close to you. If a provider does not accept insurance, contact your health insurance company and ask if you can file claims after receiving the treatment to help cover a portion of the cost. 

For additional guidance, TDCI issued this bulletin related to mental health services and created this consumer video to help explain mental health parity to consumers. 

Questions or concerns about coverage 

Tennesseans who have their claim denied or believe their insurance company is not covering mental services at the same rate as physical services should file a complaint with TDCI.  

TDCI’s Consumer Insurance Services team will mediate between the consumer and the insurance company to help facilitate a solution. In 2021, Consumer Insurance Services recovered $8.2 million from insurance companies for Tennesseans through these efforts. 

To file a complaint, visit TDCI’s website, select File a Complaint, then complete and submit the online complaint form.  

For more information, call 615-741-2218 or 1-800-342-4029. 

TDCI encourages anyone who has thoughts of self-harm to contact the Tennessee Crisis Line at 1-855-274-7471.