The Challenge of Paying for Mental Health Care
February 21, 2023
Nothing is more important than physical and mental well-being. However, it can be challenging and frustrating when you are the caregiver helping someone else get and pay for the mental health care they need.
Some mental health treatment options are covered by insurance, while some are not. Your loved one might need to see a specific provider who doesn’t accept your insurance. The same mental health treatment or provider might be covered by one insurance plan but not another. As a result, many people receiving treatment pay out of pocket (with their own money because they are not paid for by insurance) for these expensive but vital services that help them live healthy lives.
Real-Life Experiences of Paying for Mental Health Care
When you are struggling to help someone else get the care they need, it can feel like you are alone. We talked with four caregivers whose experiences might be similar to yours. Like you, they are using all the resources available to them so their loved ones get the treatment they need. We hope that their stories and advice will help and reassure you that you are not alone in facing these challenges.
Anne is the primary caregiver for her child, who is living with bipolar disorder. Her adult child (over the age of 25) is on her employer-supplied medical plan, but it does not cover everything.
Anne’s child has required “numerous hospitalizations and therapists.” She explains the challenges they face with paying for these services. “Apparently, due to state and insurance limitations, after a specified number of sessions, payment ceases, and it’s back to square one.”
Often, they must pay for treatment out of pocket. Anne says one of the biggest issues is “limited resources and medical personnel. In all aspects of treatment and necessities. The negative stigma attached to mental illness has made it very difficult for continuous treatment to lead to recovery and a better way of life.”
Anne offers this advice to other caregivers experiencing the same challenges. “Getting quality mental health care is possible but very difficult to find. The limited resources that are available are spread so thin that personalized attention is rare. Show unconditional love to your family member in need and be willing to be in the race to the finish line. They will not/cannot finish the race without you.”
Melissa is the caregiver for her young son (under 18) and paying for care hasn’t been easy. Unfortunately, her health insurance plan does not cover any of his care. Instead, they use Ohio Medicaid to get care for his depression. He has been seeing a counselor every week for roughly three years. The ongoing visits add up.
Melissa identified specialists for her son by getting referrals from his primary care provider. As his caregiver, she supports him by scheduling his appointments and making sure he arrives on time.
The biggest challenge in getting Melissa’s son the care he requires is finding a good health care provider close to home who will accept his insurance.
Because of her experience, Melissa says, “I understand that mental health treatment can be very expensive, and it would be helpful if providers would work on a sliding scale for fees like medical providers.” She has found that “most ‘teaching’ hospitals have resources to assist with facilitating treatment at low cost or free clinics.”
Thomas is the caregiver for his mother, who lives with depression. She is over the age of 65. He helps her by coordinating her treatments.
Thomas’ mother uses Medicare to pay for her mental health care. Their biggest challenge is transportation. He does not own a vehicle. and the providers she relies on are not close to their home. Due to the transportation issue, his mother often stays home but receives clinical and social worker visits.
Thomas knows his mother is fortunate to have health coverage. His observation on the state of the mental health system: “It’s great to have Medicare, but those who don’t will be billed through the nose.”
Gwen is the primary caregiver for her adult child (18-25). Over the past two years, she has helped her son get services for depression by finding providers, scheduling appointments, providing reminders, and driving him to appointments.
Currently, her child is on her private insurance policy. But the plan does not cover all the treatments her son needs. They have paid his out-of-pocket expenses for providers who do not accept their insurance.
Her son requires weekly therapy and a psychiatrist visit once a month. He has also participated in outpatient programs and utilized inpatient services years ago.
She explains the most significant challenge for paying for mental health care that they have faced. “Psychiatrists who are good and who take enough time to get to know our son usually have not taken our insurance. When we went to doctors who took our insurance, they were rushed, often not as prepared for appointments, and did not get to know our son.”
Gwen wants others to know that “they have the right to speak up if they feel they are being rushed or if they are not getting good care from their provider. It can be worth the extra time and research to find a provider that takes your insurance. Their loved one may qualify for supplemental public insurance (such as Mass Health or other Medicaid program) due to their condition, which can ease costs.”
Options for Help Paying for Services
Although caregivers and people living with depression or bipolar disorder may experience challenges getting the services they need and paying for treatment, there are options.
Families for Depression Awareness has created a helpful fact sheet offering practical advice about paying for mental health care. We hope this information helps you navigate paying for care so your loved one gets the treatment they need and deserve.
Dawna M. Roberts has spent most of her career in technology. She has written thousands of blogs, marketing materials, and website pages for her clients. She owned a website development agency for 15 years, honing her SEO and digital marketing skills. Writing and storytelling are her passions, and she enjoys crafting well-written, compelling content that keeps readers coming back for more. Her biggest joy is writing that helps other people.