Doctor's office
Enter your doctor's name to get office information.
Find labs in your network
Enter your primary care doctor's name to find labs in your network.
Find urgent care centers in your network
Enter your primary care doctor's name to find urgent care centers in your network.
Verify your medical group

Refer to your insurance card or call your insurance provider to determine your medical group.

You can also search for your primary care doctor to find the medical group you and your doctor belong to.

Driving Directions
Update Information
Forgot Password

Please enter your e-mail address.

Sharp Health News

How well does your insurance cover mental health care?

May 5, 2022

Therapy session between patient and doctor

The COVID-19 pandemic has many of us thinking about what we would do if we required medical care. Where would we go for treatment? Would our insurance cover it? How much would we have to pay out of pocket?

However, it has been proven that COVID-19 affects more than our physical health. The Centers for Disease Control and Prevention (CDC) reports that communities across the U.S. face mental health challenges related to the coronavirus pandemic. From the sickness and death the disease causes, to the loss of work and need for social distancing and distance learning, COVID-19 and its related consequences can lead to isolation, depression and anxiety.

In fact, in September 2020, researchers found that adults in the U.S. reported struggling with mental health concerns or substance use:

  • 33% reported anxiety or depression symptoms
  • 15% reported increased substance use
  • 12% seriously considered suicide
  • 30% reported COVID-19-related trauma symptoms

"These mental health concerns are not only pervasive during unprecedented times, such as the one we're now experiencing," says Dr. Lisa Arian, senior medical director at Sharp Health Plan. "Even without a looming pandemic, approximately 1 in 5 American adults experience mental illness. For these individuals, and many others, mental health coverage is paramount."

The ACA and mental health care coverage
According to Don Truong, director of sales at Sharp Health Plan, the Affordable Care Act, also known as the ACA or “Obamacare,” ensured that individual and family plans and small employer group plans cover mental health and substance use services as essential health benefits. There are also California laws that require coverage of treament for mental health and substance use disorders for all individual and employer group plans (both large and small). Therefore, health plans in California must cover behavioral treatment, such as psychotherapy and counseling, mental health inpatient services, and substance use disorder treatment.

“Additionally, preexisting mental health and substance use conditions are covered,” Truong says. “And plans cannot put limits on coverage of these essential health benefits."

Medicare, the federal health insurance program for people who are 65 or older and certain younger people with disabilities, also covers counseling, inpatient services and substance use disorder treatment. Medicare Advantage Plans, which are "bundled" plans offered by Medicare-approved private companies, vary in the mental health services they cover. You can compare the quality of Medicare health and drug plans using Medicare's Star Ratings system, which rates plans on a one-to-five scale.

Dr. Arian and Truong recommend that you take the time to review a plan's network of doctors and the medications covered before enrolling. You also want to familiarize yourself with the level of customer service that support plans provide.

"It is important to do your research about the doctors and therapists within a plan's network, as well as the services and medications covered," Truong says. "For example, Sharp Health Plan offers over 250 behavioral health providers for our members to choose from."

Dr. Arian says that Sharp also makes getting care convenient with video visits. What’s more, no referral is needed for outpatient therapy with a provider in your network.

Sharp HealthCare accepts almost all health insurance plans, including Sharp Health Plan. Learn more about purchasing individual insurance.

You might also like:

Choose the doctor who's right for you.

At Sharp, we make it easy to find an exceptional doctor — right where you live and work.

All Categories
Contact Sharp HealthCare
Call us

Call 1-800-827-4277 or view our detailed phone directory.

If you are experiencing a medical emergency, call 911 or visit the nearest emergency room.

Email us

Please do not use this form to convey personal or medical information.

How would you like to be contacted?
Date of birth

What's This?

These important numbers are located on your billing statement.

Find your Sharp Rees-Stealy account number

Find your SharpCare account number

Find your SharpCare account number
What's GDPR?

The General Data Protection Regulation (GDPR) governs the processing of personal information gathered from individuals while they are in the European Union (EU) and parts of the EEA (European Economic Area, which currently includes Iceland, Lichtenstein and Norway).

We are sorry, but we are unable to process your price estimate if you live or are travelling within the EU or affiliated nations.

What's This?

Many surgery and procedure names sound similar. If possible, please provide the current procedure terminology (CPT) code, which can be found on the order from your doctor.

If you cannot provide the CPT code, please contact your doctor's office for the CPT or a detailed description of services.