When your teen needs help for their mental health, the last thing you want to worry about is trying to afford it. However, it might be the first thing on your mind. Insurance is one of the most valuable tools for affording healthcare services, but does insurance cover residential treatment?
Call Family First Adolescent Services at 888.904.5947 now. We can help you determine if our teen residential treatment program is right for your child and if your insurance could help cover some of the cost.
What Is Residential Treatment?
Residential treatment is a type of mental health care where individuals live on campus and receive round-the-clock care. This form of treatment is especially beneficial for teenagers struggling with mental health issues, substance use disorders, or behavioral problems.
A safe, secure environment staffed by trained professionals can provide teens with the support and structure they need to heal and develop healthy coping mechanisms.
Insurance Companies Offer Equally Favorable Benefits
Several laws and policies surround insurance coverage, allowing parents to access mental health treatments for their teenagers. The Mental Health Parity and Addiction Equity Act (MHPAEA) passed in 2008 requires most insurance plans to offer equal benefits for mental health and substance use treatment as they do for medical and surgical care. The Affordable Care Act (ACA) also expanded insurance coverage by classifying mental health and substance use treatment as essential health benefits that insurance plans must cover.
It’s important to note, however, that there are some exceptions and limitations to insurance coverage for residential treatment. For example, some plans may have different coverage levels depending on the type of treatment or services provided. It’s best to contact your insurance provider directly to understand your specific coverage.
Does Insurance Cover Residential Mental Health Treatment?
The answer largely depends on your specific insurance plan. Most health insurance plans provide some level of coverage for mental health services, including residential treatment. However, the extent of coverage can vary widely. Insurance plans commonly cover:
- Inpatient care, including residential treatment
- Outpatient therapy and counseling
- Medications prescribed by a doctor or psychiatrist
It’s crucial to research your insurance policy carefully and speak with a representative to fully understand what is covered. Keep in mind that some plans may require pre-authorization for residential treatment coverage, meaning you must get approval from the insurance company beforehand. Or, some services may only be partially covered, leaving you with out-of-pocket expenses.
Tips for Maximizing Insurance Coverage
Here are a few strategies to help you maximize your insurance coverage for residential treatment:
- Understand your policy – Review your policy carefully to understand what is covered and what isn’t.
- Document everything – Keep detailed records of all correspondence with your insurance company and treatment providers.
- Seek pre-authorization – Before beginning treatment, get pre-authorization from your insurance provider to ensure coverage.
- Advocate for your child – In case of coverage denials or limitations, be proactive in advocating for your child’s needs and provide any necessary documentation to support their treatment.
Reaching out to treatment centers can also help you navigate the insurance coverage process. They will often have experience dealing with insurance companies and can assist you in understanding your coverage and potential costs.
When to Consider a New Insurance Plan
If you have an employer-sponsored insurance plan, consider your teen’s mental health when choosing your insurance coverage during open enrollment. Some plans may offer more comprehensive coverage for mental health services than others. Additionally, if you are not satisfied with the coverage of your current plan, you can explore other options during open enrollment as well.
You may be able to find a plan that offers lower co-pays for mental health treatment or better coverage for mental health medication if your teen requires it. It may also be worth considering switching to a plan that offers coverage for residential treatment, even if your teen is only in outpatient therapy. Mental health changes over time, and it’s always beneficial to have comprehensive coverage in case your child needs more intensive treatment in the future.
Also, consider health savings accounts (HSAs) or flexible savings accounts (FSAs), which allow you to save pre-tax dollars specifically for medical expenses, including mental health treatment. These accounts can help offset the cost of residential treatment if your insurance coverage is not enough.
Call Family First Adolescent Services for Teen Residential Treatment
Does your insurance cover residential mental health treatment? Find out so you can get your teen help today.
The Family First team is dedicated to helping your family find the best treatment options for your teen. Our residential treatment program is designed specifically for teen boys 13–18 years old, providing a safe and supportive environment for healing and growth. Call 888.904.5947 or contact us online now.