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12-15 Hung out to dry: A teenager’s need for mental health care coverage

Hung out to dry: A teenager’s need for mental health care coverage

“I cannot make you understand. I cannot make anyone understand what is happening inside me. I cannot even explain it to myself,” wrote Franz Kafka in his short story, “The Metamorphosis.” Similar to the character in this story, many teens struggle with mental illness and are denied the proper care they need; proverbially leaving them to hang out to dry on their own.

Available alternatives at a low cost

Even when young people are included on their parent’s insurance plan until they are 26-years old, mental illness coverage may not be included. In 2012, The National Health and Nutrition Examination Survey, found only around 50 percent of children with mental disorders received the proper treatment.

While most forms of mental illness are treatable, insurance may not cover the level of treatment needed. For teenagers not covered by their parent’s plan, alternative options are available. Kidshealth.org lists a few alternative options to acquire mental health care for a teenager in need, including, but not limited to:

  • School counseling
  • Mental health centers or clinics
  • On-campus health services for college students
  • Private therapists

School counseling is free for current students and as kidshealth.org states, “They can help you size up the situation you’re dealing with and, if needed, refer you to more support in your county or community.” Local mental health centers are another option and, “Charge less than you might pay a private therapist.” Utilizing these services is a step in the right direction but may not provide all resources necessary for a teenager’s mental health treatment.

Besides alternatives, a parent can appeal the denial of coverage from a health care provider.

Don’t just sit there, appeal

The State Children Health Insurance Program consists of, “A partnership between the Federal and state governments that provides health coverage to uninsured children whose families earn too much to qualify for Medicaid, but too little to afford private coverage.”

There are a multitude of reasons for an insurance agency to deny mental health care coverage for family members. However, the National Alliance on Mental Illness, or NAMI, describes what can be done when mental health care coverage is denied. A few reasons one can decide to appeal, include:

  • Believing one is entitled to the mental health care service.
  • Mental health concerns not being held equal to other health concerns by insurance provider.
  • Teenager not being covered for mental health care and treatment.

“The equal treatment of mental health and other health conditions under insurance plans is referred to as mental health parity,” NAMI adds. Most health care providers, “… are required to follow federal and state mental health parity laws,” and many in fact state this in formal appeals.

The process of an appeal begins with speaking to one’s mental health professional. Be sure to communicate with providers about the reason for appealing; NAMI offers a mock-letter for site visitors to use as a guideline for their own appeal. Insurance companies may have their own forms to fill out and their own protocol for the appeal process; speak with them first and acquire all needed materials.

If an insurance company is denying mental health coverage, the options above could help the teenager in need receive treatment. In some cases, a teenager may need care at an inpatient facility. Sovereign Health of Rancho San Diego strives to help teenagers dealing with substance abuse and mental health issues get back on track. The Sovereign Health Group offers personalized treatment methods to treat all co-occurring conditions. Call our 24/7 helpline to learn more and begin treatment today.

Written by Nick Adams, Sovereign Health Group writer

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