Who can help me deal with the obstacles my health insurer has put in the way of my mental health care?

I have never forgotten that response from a long-time colleague after I had reached out in a moment of frustration regarding a particularly problematic project of mine. She said, “Don’t focus on what others should be doing to solve your problem. Figure out that certain something you can do to help yourself.”

Accessing care for mental health or substance use disorders can bring its own frustrations and a sense that nothing is moving forward. The cost of care and uncertainty about getting insurance coverage may be among the most significant concerns.

Nearly 60% of adults with mental illness report that they did not receive treatment because they thought it would cost too much, according to the 2023 National Survey on Drug Use and Health from the Substance Abuse and Mental Health Services Administration. Hearing stories of insurance denials of care can be discouraging.

So, what has Cover My Mental Health done about it?

We launched Cover My Mental Health to address these challenges and provide support at the point of an insurance crisis.

At www.covermymentalhealth.org, you can find no-cost, immediately-actionable resources to help overcome insurance obstacles to care:

• Our tools can help you document that you’ve searched  the insurer directory and cannot find an available, in-network clinician.
• Our downloadable templates can help you secure a letter from your clinicians when your health insurer has denied care claiming it’s not “medically necessary.” That template letter helps your clinician document that they are fully-trained, competent to make clinical decisions, and in the best position to know what treatment is appropriate.

Here’s how one person used our medical necessity letter template to secure insurance coverage for severe anxiety care:

“I was in a car accident in February. I had previously dealt with significant car-related anxiety, to the point where I found it difficult to be a passenger in the car. My insurance company offered $5,000 of medical coverage for the accident, and I wanted to spend some of that on mental health services to deal with my anxiety post-accident, but I was not sure if mental health would be covered. Cover My Mental Health provided resources, including a template letter of medical necessity that I could give to my mental health care team. The letter detailed the reasons why mental health services were necessary following the accident and outlined a treatment plan. I sent the letter to my insurance company, and they reimbursed me for mental health services, no questions asked!”

In addition to worksheets and template letters, Cover My Mental Health also provides a range of tips for dealing with insurance companies to guide your efforts overcoming an insurer’s obstacle. Our resources provide you with actionable steps you can take to address, and ideally resolve, your insurance claim issue early in the process.

Health insurers may advise you to file an appeal if you disagree with their decision or have a dispute. However, appeals are rather legalistic and can follow a process that may favor the insurance company, so appeals may not be the best place to start. Cover My Mental Health provides numerous steps to take to resolve an issue before any appeal is initiated.

So, with the resources of Cover My Mental Health at hand, it may be just a little easier to answer the question, “Who can help me deal with my health insurer standing in the way of my mental health care?”