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. 

A Growing Problemblack silhouette of a person sitting with their knees to their chest and pieces of the back floating away

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.

Mental Health Issues On The Rise

Mental illness does not discriminate. It affects people of all ages, genders, ethnicities, and socio-economic classes. Health insurance claims for the treatment of depression, anxiety, and other mental disorders have been steadily rising over the years. Recent job losses and stay-at-home orders have made things even worse, with federal agencies and experts warning that a wave of depression, substance abuse, PTSD, and suicide is on its way. Our already underfunded mental health system is at risk of being overwhelmed. 

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“If we don’t do something about it now, people are going to be suffering from these mental-health impacts for years to come,” said Paul Gionfriddo, president of the advocacy group Mental Health America. “That could further harm the economy as stress and anxiety debilitate some workers and further strain the medical system as people go to emergency rooms with panic attacks, overdoses and depression.”

High Numbers Among Young Adults & Adolescents

While mental health claims among all Americans have been going up, data reported by FAIR health, a nonprofit database of more than 28 billion private healthcare claim records, shows that they are shockingly high among young adults and adolescents, Between 2007 and 2017, mental health claims relating to depression and anxiety in young people were especially high. 

In 2007, young people accounted for 15% of all claims tied to serious depression. By 2017, they accounted for 23%. Claims for anxiety also grew more common among young people. Between 2007 and 2017, claim lines for generalized anxiety disorder rose 441% among young people ages 19-22. The report also found that behavioral health diagnoses rose 108% from 2007 to 2017.

Suicide Numbers Risingred arrows going up

Suicide rates are also on the rise, with many worried that an increase in mental health issues combined with our current stressful environment could make things worse. A report issued by the CDC found that suicides are up 30% since 1999, and only half of those who died were diagnosed with a mental health disorder prior to their deaths. Unfortunately, many people suffer in silence, and added stresses such as job loss, or relationship, financial, or health problems, can lead to disastrous consequences. 

Meadows Mental Health Policy Institute, a Texas nonprofit, created models estimating that if unemployment rates continue to rise to a level similar to the Great Recession, then an additional 4,000 people could die by suicide and an additional 4,800 could die from drug overdoses.

Mental Health Coverage

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All ACA-approved plans must cover behavioral health treatment, such as psychotherapy and counseling.

Some experts point out that it’s unclear whether more people are suffering from mental illnesses, or whether we’re getting better at talking about it, recognizing it, and treating it. According to Dr. Stephen Strakowski, a psychiatrist at the University of Texas at Austin’s medical school, “It’s very hard to disentangle [increased prevalence] from increased recognition, more people accessing care, and people being willing to fill out forms more honestly.” 

Research shows that people who need mental health care are more likely to get it now than they were at any time in the past, but things are not perfect. There are still many people who aren’t getting the help they need because they don’t have mental health insurance coverage. Fortunately, as of 2014, the ACA requires all Marketplace healthcare plans to cover mental health and substance abuse services.

All ACA-approved plans must cover:

  • Behavioral health treatment, such as psychotherapy and counseling
  • Mental and behavioral health inpatient services
  • Substance use/abuse disorder treatment

Employer-based health insurance, Medicaid and Medicare all offer mental health and substance abuse coverage. It is important that people are encouraged to use this coverage to get screened for suicidal thoughts, to treat any underlying mental conditions, and to access therapy. Seeking help makes a difference. 

If you or someone you know is showing warning signs of suicide, help is one call away. For free 24/7 crisis support:

  • Call the National Suicide Prevention Lifeline: 1-800-273-8255.
  • Text Crisis Text Line: Text HOME to 741741
  • Call Substance Abuse and Mental Health Services Administration: 1-800-662-4357