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Mental health awareness: Know what’s covered

By Oklahoma Insurance Commissioner Glen Mulready

May was National Mental Health Awareness Month and many people have been experiencing greater stresses since the COVID-19 pandemic. Many families are still facing economic challenges and anxieties about the health of loved ones. In honor of Mental Health Awareness Month, I would like to take a moment to remind Oklahomans that all comprehensive major medical insurance plans are required by law to cover mental health and substance abuse services.

Under Oklahoma law, health insurers offering comprehensive health insurance plans must have an adequate network of providers and treatment facilities for mental health and substance use disorder conditions. They cannot limit the number of visits you make to such providers and cannot charge greater co-pays for outpatient mental health and substance disorder services than other primary care medical services. Here is some helpful insurance information to help you understand your access to mental health services.

Mental Health Coverage Options

The federal parity law generally applies to the following types of health insurance:

Employer-sponsored health coverage for small groups (under 50 employees) and large groups (over 50 employees).

Coverage purchased through health insurance exchanges created under the health care reform law also known as the Affordable Care Act (ACA).

Children’s Health Insurance Program (CHIP).

Medicaid program (SoonerCare). Requirements may vary, contact the Oklahoma Healthcare Authority if you are unsure how the federal parity law applies to your Medicaid benefits.

Eligibility and Claim Issues

Check your description of plan benefits — it should include information on behavioral health services or coverage for mental health and substance use disorders. If you still aren’t sure, contact your insurance company directly or contact us at 800-522-0071.

If your mental health claim is denied, always ask why. Your health plan will have a process to review and appeal denied claims. You or your provider may also file a complaint with us. Check out the National Alliance on Mental Illnesses’ tips for what to do if you’re denied care by your insurance carrier.

Additional Resources

For more information on consumer rights and protections, visit our Mental Health page at www.oid.ok.gov/mentalhealth. You can also visit the Oklahoma Department of Mental Health and Substance Abuse Services at https://www.ok.gov/odmhsas or call 2-1-1.

When it comes to our well-being, mental health is just as important as physical health. Check with your health insurance company to find out what options are available. Many plans offer special hotlines or cover mental health visits through telehealth. If you need help, please reach out.

For more insurance information, please contact the Oklahoma Insurance Department at 1-800-522-0071 or visit our website at www.oid.ok.gov.