Mental Health Insurance For Children

Children’s Mental Health Awareness Week is February 1st – 7th, and we want to take this time to focus on the mental health of children. The CDC estimates that approximately 1 in 5 children are dealing with mental, emotional, or behavioral disorders, and unfortunately only 20% receive care. Untreated mental disorders and mental illness in children can lead to dropping out of school, substance abuse and even suicide. Early diagnosis and treatment are vital for avoiding these outcomes, so finding a comprehensive health plan is an important step towards keeping your children safe and healthy, both physically and mentally. 

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Mental health claims have been on the rise since 2017. The pandemic has been making the problem worse, and even causing an increase in suicides. Children have been just as affected as adults by current events: they are now glued to screens for school, and are dealing with increases in cyberbullying and anxiety. Being isolated in their homes could be the reason behind a sharp increase in mental health crises among children. In fact, the CDC has reported that, from March through October of this year, the share of mental health-related hospital emergency department visits rose 24% for children ages 5 to 11, and 31% among adolescents ages 12 to 17, when compared to the same period in 2019.

ACA Mental Health Coverage

All Affordable Care Act (ACA)- approved health plans must cover essential mental health benefits, including:

  • Screening for mental health conditions 
  • Behavioral treatment
  • Mental and behavioral health inpatient hospital services
  • Pre-existing mental and behavioral conditions
  • Substance use disorder treatment

The Mental Health Parity Act of 1996 requires that insurance coverage cannot have more restrictive requirements for behavioral health coverage than it does for physical health like medical and surgical services. This means that you or your child can seek treatment such as group therapy, psychotherapy, and medications to help treat mental health issues in the same way that you would seek treatment for a physical ailment.

Employer-Based Coverage

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Employer coverage must have mental health health benefits, and you can check exactly what is covered in your summary of benefits.

All employer-based plans must comply with ACA requirements for mental and behavioral health, including parity protection laws. If you have employer-based coverage, look at your plan’s summary of benefits to see what level of coverage you have for mental and behavioral health. If you find that your plan does not provide enough coverage, you can opt out of your employer’s plan and choose to purchase an individual health insurance plan instead. 

You can also ask your employer about Employer Assistance Programs (EAPs), which can include mental health counseling and support. Some programs are available at no cost, and some employers might cover the fees if their health plan does not. 

Individual Coverage

The ACA Marketplace or private insurance plans are great options for affordable coverage that meets your medical needs. All plans comply with ACA regulations on mental and behavioral health coverage, and it is possible to find a plan that offers more coverage or has lower copays if you speak with an EZ agent.

Unfortunately some families cannot find mental health care because of lack of providers in their area, or some cannot afford the cost of services. If you come to EZ, one of our agents will check each available plan’s network of doctors and medication costs to find a plan that is affordable and meets your needs. We will work with you to find an in-network mental health provider close to your area, and we will make sure that your medications are covered under your plan’s formulary. To get free instant quotes, simply enter your zip code in the bar above, or to speak with an agent, call 888-350-1890.

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