The Affordable Care Act (ACA) requires all qualifying plans to cover essential mental health benefits. Mental health insurance policies must include free depression screening, behavioral health treatment, mental and behavioral health inpatient services, and substance use disorder treatment (commonly known as substance abuse).
The best mental health insurance companies should include ACA essential benefits with every plan, plus highlighted “extras” the carrier deems important, like telemedicine coverage or wellness benefits that go beyond what the health care law requires. Mental and behavioral health can be ongoing and costly, so these companies should help ease the financial burden for treatment while providing additional benefits to help stabilize mental wellbeing.
Best Overall : UnitedHealthcare
We selected UnitedHealthcare for the best mental health insurance overall because of its extensive network for care, abundance of online resources, and comprehensive coverage for behavioral health.
24/7 virtual mental health visits
Mental health mobile app
Waived office copay from college student health center
Treatment for addictive gambling
Extensive provider networks
Limited state availability for individual ACA coverage
Higher cost premiums
Difficult finding pricing online
UnitedHealthcare offers health plan benefits to individuals, employers, Medicare, and Medicaid beneficiaries. It has earned a financial strength rating of “A” by AM Best, the largest independent credit rating agency in the world specializing in the insurance industry.
Today the company partners with more than 1.3 million physicians and care professionals plus 6,500 hospitals and other care facilities nationwide. Out-of-network benefits are included with mental health insurance plans, but they do cost more than in-network providers.
UnitedHealthcare policies can cover people from infancy to Medicare nationwide, with supplemental coverage to fill any policy gaps along the way. Its product portfolio for individuals includes:
- ACA individual insurance
- Group insurance
- Short-term medical
- Student insurance
- Dental/vision insurance
- Supplemental insurance
For ACA individual insurance, UnitedHealthcare provides coverage in seven states. Deductibles range from a little more than $2,000 to $7,500 for ACA qualified health plan coverage you can buy online. Deductibles differ based on coverage (employer vs. individual) and metal level purchased. For a 32-year old male living in Fairfax, Virginia, the total out-of-pocket maximums would be $8,550, which includes meeting the deductible, coinsurance, and copayments. It doesn’t, however, include the monthly health insurance premium.
Insurance companies for mental health are required by the ACA to provide pharmacy benefits. In 2019, nearly 20% of Americans sought mental health treatment, with nearly 16% taking at least one prescription drug. Depending on your mental health insurance plan, UnitedHealthcare prescription drug coverage can include mail orders, a customized pharmacy mobile app to manage your drugs, and on some plans, a large network of both retail and independent pharmacy in-network options.
Best for Telehealth Coverage : Cigna
We selected Cigna as the best for telehealth coverage based on the company’s commitment to expanding its telemedicine reach.
24/7 telehealth access
Expanded Bronze plans available
In-person office visit copays available on select plans
Out-of-network mental health services not covered
Not all plans have telehealth access
Cigna is a global company rated A by AM Best with more than 180 million customer and patient relationships. Since 2016, the company has committed to growing its mental and behavioral health care network and now boasts more than 175,000 mental health providers in-network, a growth rate of 70%.
Evernorth, a Cigna subsidiary, recently acquired MDLive, a 24/7 telemedicine company that provides most Cigna members telehealth services without working through a third party like other health insurance carriers. MDLive can treat conditions like minor medical conditions, preventive wellness screenings, and behavioral health services. Mental health visits can be scheduled in about seven days. (Of note: Behavioral health counseling may not be available with all plans.) Doctors are board-certified and have on average more than 15 years of experience. Psychiatrists and licensed therapists are available for:
- Bipolar disorder
- Grief and Loss
- Panic disorders
Cigna offers coverage to employers as well as qualified ACA plans for individuals and families. Cancer, heart attack and stroke, hospital indemnity, and whole life insurance can be purchased as a supplemental plan. Medicare-aged seniors have a choice of Cigna Medicare supplement, Medicare Advantage, and Part D plans. Dental insurance policies are also available.
Many qualifying ACA plans offered by Cigna are health maintenance organization (HMO) plans. HMOs are doctors, hospitals, and other healthcare providers who have agreed to accept payment at a certain reimbursement level for any services they provide “in-network.” Some plans may accept telehealth visits as an in-network benefit and charge a copay rather than a flat fee for service.
Off-exchange health insurance deductibles range from $2,500 to $8,550. For a 32-year old male living in Phoenix, Arizona, the average health insurance premium without a Marketplace subsidy runs from $321 to $509 per month. The higher the deductible, the lower the monthly premium and vice versa. No private insurance HSA plans are available, although Cigna does offer “expanded” Bronze plans which pay for at least one major service other than preventive care before the deductible is met.
Best For Affordable Policies : Ambetter
Ambetter serves over 2.2 million customers with health insurance both on- and off-exchange in more than 400 counties in 20 states. Its private health insurance pricing makes it the best health insurance with affordable health care costs and ways to save for those seeking qualified ACA coverage with mental health benefits.
Lower-cost monthly premium pricing
$0 copay telehealth services
My Health Pays rewards program
State-based benefits for customized care
Difficult to find consumer reviews
Limited product portfolio
$0 telehealth copay doesn’t apply to HSA plans until deductible is met
Ambetter, a Centene Corporation affiliate rated BBB- by Fitch Ratings, is the largest provider of federal and state health insurance Marketplace plans nationally. Founded more than 30 years ago as part of the managed care industry, it now owns insurance entities including Wellcare, Health Net, and Celtic Insurance Company, the policy underwriter for Ambetter plans.
Every Ambetter Marketplace plan covers essential health benefits as mandated by the ACA. These benefits include emergency services, outpatient or outpatient services, preventive and wellness care, maternity and newborn services, pediatric care, mental health and substance abuse services, laboratory services, prescription drugs, therapy services, devices, and hospitalization.
The My Health Pays Program from Ambetter allows members to earn up to $500 in rewards for maintaining their health and participating in a healthy lifestyle, which can help manage mental wellness. Insureds receive reward points which can be used to shop for items in the Ambetter online store or converted into dollars to spend on health care expenses or insurance costs like monthly premium payments, doctor copays, and coinsurance.
To keep premiums economical, Ambetter offers health insurance plans with a variety of deductibles and coinsurance. Bronze Marketplace plans are the most affordable but also have higher out-of-pocket expenses. A 32-year old female living in Phoenix, Arizona, can get a $0 to $6,450 deductible starting at $332 per month. Silver plans are the most standard, but Ambetter offers Gold plans for maximum coverage with a $1,150 deductible.
Best For Prescription Coverage : Oscar Health
Founded in 2012, Oscar Health, Inc. was built as a technology company with a consumer-focused full-stack platform that includes high-touch member guidance and engagement. Built on that core of service, Oscar offers some of the most competitive prescription drug benefits in the market for individual and family plans.
$3 select mental health prescriptions
Cigna & Optum networks in certain states
$0 primary care in select states
Care team assigned upon enrollment
Limited coverage availability
Preauthorization may be required for non-office mental health services
Oscar Health reports that 29% of adults skip their medications due to costs. To combat this, Oscar developed a list of 88 prescriptions that represent 90% of the use cases that someone might need a pharmacy for, including mental health drugs. The company has committed to continue expanding its $3 drug list, asking members to help them determine what drugs should be included in the future.
The $0 Virtual Primary Care product is available in 10 markets as of 2021 in five states: Texas, Florida, California, New York, and Colorado. In these markets, members get unlimited and free virtual primary care visits. Visits also include certain prescriptions, durable medical equipment, lab tests, diagnostic imaging orders, and initial specialist referrals prescribed by an Oscar primary care provider according to the company.
High deductible health plans start at $8,550 for the lowest-cost Bronze plan. Oscar also offers a $0 deductible plan, with flat-rate copays under $100 for a majority of services, including doctor office visits, imaging, counseling, and more. The downside to the $0 deductible plan from Oscar is a high prescription drug deductible instead.
In addition to its technological know-how, Oscar is known for its customer service. Every member is assigned a Care Team the first time they contact the company with questions. Care Teams are led by a board-certified nurse to help ensure specialists from every segment of the insurance journey are covered. Team members can help individuals find in-network doctors, help prepare patients for upcoming appointments and answer questions about claims, billing, and more.
While known as a customer service-friendly tech company, Oscar has a higher than normal complaint index rating for individual accident and health insurance by the National Association of Insurance Commissioners. Nearly half of complaints from 2018-2020 are for handling prompt claims payment.
Best Additional Resources : Kaiser Permanente
We choose Kaiser Permanente as the best for additional resources because of its commitment to mental wellness through technology to improve sleep, mood, relationships, and overall health.
Free app integration for mental wellness
$0 deductible health plan options
Insurance carrier is owned by network provider
High ratings for quality of care
Limited state availability
Lack of transparency about complaints
Headquartered in California, Kaiser Permanente is both a health insurance carrier and a medical provider group. The not-for-profit organization, which is rated AA- by Fitch Ratings, serves more than 12 million members in eight states and the District of Columbia. Health insurance plans sold include employer, individual, and family plans, including ACA plans, Medicare, and Medicaid.
In addition to clinical support, Kaiser provides its members access to online telehealth apps like Calm, Whil, and Headspace to help reduce anxiety and better sleep routines. Apps can be downloaded to a smartphone or computer desktop. In-network clinicians also can refer patients to Thrive, SilverCloud, and myStrength to help provide coaching between appointments through interactive behavioral activities.
Calm and myStrength are available to members for free without a referral and can be downloaded from the Kaiser website or member portal. Other apps are only available for free with a provider recommendation, which can be obtained during an appointment or through the organization’s medical record system.
Like most qualifying ACA plans, Kaiser health insurance offers co-payment options for doctor office visits, including outpatient mental health appointments.
Deductibles start at $8,550 for lower-cost plans but also offer a higher-premium $0 deductible plan with 20% coinsurance. The plan includes certain benefits with set copays and other services that go towards the 20% coinsurance percentage. The maximum out-of-pocket for Kaiser plans is $8,550.
Overall Kaiser provides a combination of top-level primary and hospital care with a health insurance plan, giving members seamless service when needing the medical side to work with the health insurance company when it comes to claims.
There are many health insurance companies to review when purchasing a health insurance policy independently from an employer, especially when considering insurance companies for mental health.
We ranked UnitedHealthcare as the best mental health insurance overall for its all-encompassing benefits from telemedicine to specialized addiction care to network size and mobile technology access.
Compare the Best Mental Health Insurance
|Company||Plans||Providers In-Network||Deductible||States Available|
|8||1.3 million||$2,000 to $7,500||7 states|
Best Telehealth Coverage
|5||1.5 million||$2,500 to $8,550||15 states|
Best For Affordable Policies
|2||State-based||$0 to $6,450||20 states|
Best For Prescription Coverage
|3||State-based||$0 to $8,550||18 states based on county|
Best For Additional Resources
|3||875,000||$0 to $8,550||9 states|
How to Choose the Best Mental Health Insurance
Here are the most important factors to consider when comparing the best mental health insurance companies.
- Plan deductible: In most cases, you’re responsible for the plan deductible before the insurance company begins to pay medical bills. Can you afford to pay the amount out-of-pocket?
- Coinsurance: Does the plan have coinsurance you’re responsible for after the deductible? Lower-priced plans typically have coinsurance. Higher-priced plans can many times have $0 coinsurance.
- Copays: Are copayments important to you for primary care? Are there copays for outpatient mental health care like counseling? Copays can lower your out-of-pocket expenses rather than strictly paying towards a deductible amount.
- Telehealth: What kind of telehealth counseling or therapies are available? Is it free or a lower cost compared to in-person counseling? Telemedicine typically costs less than in-person visits.
- Prescription drugs: What will your responsibility be for prescription drug costs out-of-pocket? Is there a drug deductible you have to meet first? Contact a pharmacy to get costs in advance of changing health insurance plans to know your costs upfront.
- Doctor network: Does the provider network include your doctor of choice? If you have to switch doctors to stay in-network, are the physicians located close to your area?
- Monthly premium: Can you afford the monthly cost of the health policy?
Frequently Asked Questions
What Is Typically Covered For Mental Health on a Health Insurance Policy?
Thanks to the ACA, mental health and substance abuse services are a mandated benefit covered under the law. Every qualified ACA plan must cover outpatient treatment, like therapy, inpatient services for behavioral and mental health, and substance abuse treatment. Coverage can vary depending on the plan selected and state regulations.
Health insurance plans like short-term medical and limited duration plans are not considered qualified-ACA coverage and are thus not required to offer mental health benefits.
Do Mental Health Benefits Differ Between Health Insurance Companies?
Some plans do not pay for mental health visits until a deductible is met while others offer behavioral health copays for office visits. Still others have telehealth counseling options that are either free or at a lower cost than seeing a practitioner in person. Comparing plan benefits can help determine the full range of benefits and services available.
What Is The Difference Between Inpatient and Outpatient Mental Health Care?
Inpatient mental health services include mental and behavioral health facilities where an insured person might check themselves in or be committed by a third party for 24-hour emotional care and support. Patients struggling with substance abuse, who have the potential to harm themselves, or who have not had success in outpatient therapy might find inpatient treatment a more stable form of care. Private health insurance plan benefits vary, but typically a patient is responsible for charges up to the deductible or is subject to a coinsurance percentage.
Outpatient care includes counseling and learning to manage mental health stress. It can be the best course of action for patients with problems like eating disorders, depression, and anxiety. Many times office visits are subject to a flat fee copayment, but some plans may require the medical deductible to be met before copayments or coinsurance apply.
We analyzed a variety of health insurance companies to identify carriers marketing ACA-qualifying health plans that are required to cover mental health services. Next, we reviewed plan information, including deductibles and pricing.
We also analyzed benefits schedules for policy details including exclusions. Other contributing factors for selection were state availability, financial rating from credited financial institutions, network and online services, monthly premium pricing, and company-specific “extras” for mental health.