Mental Health Coverage: A Fundamental Component of Your Healthcare

May is Mental Health Awareness Month, and at Family Benefit Services, we are dedicated to promoting access to comprehensive healthcare coverage for all individuals.

In this article, we want to highlight the importance of mental health coverage and the provisions established by the Affordable Care Act (ACA) and Medicare to ensure adequate access to mental health services. Understanding the inclusion of mental health as one of the ten minimum essential benefit packages and the commitment to equitable coverage under Medicare can help individuals make informed decisions about their healthcare plans.

The Affordable Care Act and Mental Health Coverage:
Signed into law in 2010, the ACA brought about significant changes in the healthcare landscape, including prioritizing mental health services. The legislation recognized the essential role of mental health in overall well-being and mandated its inclusion as one of the ten minimum essential benefit packages. This means that insurance plans offered through the ACA marketplace must cover mental health services on par with other medical services.

Under the ACA, mental health coverage must include a range of services, such as:

  1. Outpatient care: Counseling, therapy sessions, and visits to psychiatrists or psychologists.
  2. Inpatient care: Treatment received in a psychiatric hospital or residential treatment facility.
  3. Substance use disorder services: Rehabilitation, counseling, and medication-assisted treatment for substance abuse issues.
  4. Prescription medications: Coverage for medications prescribed for mental health conditions.

Medicare and Mental Health Coverage:
Medicare, the federal health insurance program primarily serving individuals aged 65 and older, also recognizes the importance of mental health. Mental health conditions, including depression, anxiety, and bipolar disorder, are prevalent among seniors. To ensure equitable access to care, Medicare has mandated that mental health services be covered at the same level as acute care.

Seniors enrolled in Medicare can benefit from the following mental health services:

  1. Outpatient services: Visits to psychiatrists, psychologists, and clinical social workers.
  2. Inpatient care: Hospital stays for mental health treatment.
  3. Partial hospitalization programs: Intensive outpatient programs offering structured mental health services.
  4. Prescription medications: Coverage for prescribed medications to treat mental health conditions.


As we observe Mental Health Awareness Month, it’s crucial to remember that mental health is an integral part of overall well-being. Thanks to the ACA and Medicare, mental health coverage has become more accessible and equitable.

Family Benefit Services is dedicated to empowering individuals to make informed decisions about their healthcare, ensuring they find the right plan and connect with the right providers. Let us help you navigate the healthcare system and secure the comprehensive coverage you deserve. Together, we can improve access to quality healthcare and support mental health for all.

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We are committed to assisting our clients in finding the most suitable healthcare plans and helping them access the right mental health providers. Simply call or submit your info below for more information.

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