Insurance coverage

TDCI, TDMHSAS raise awareness of insurance coverage for mental health services during Mental Health Awareness Month

NASHVILLE – The Tennessee Department of Commerce & Insurance (“TDCI”) joins the Tennessee Department of Mental Health and Substance Abuse Services (“TDMHSAS”) in reminding the people of Tennessee that May is recognized as Mental Health Awareness Month. mental health, a moment to reflect and support people who suffer from mental illness.

As with many physical illnesses, medical treatment for mental illnesses can be expensive. TDCI encourages Tennesseans and their loved ones who suffer from mental illness to understand how insurance can help cover the cost of treatment. Under the Mental Health Parity and Addiction Equity Act of 2008, any health insurance scheme that covers mental health care must match their coverage with the plan’s physical health coverage. This applies to co-payments, deductibles, number of days covered for a hospital stay, prior authorization, prescription drug levels and maximum benefit limits.

“Caring for a person’s emotional, psychological and mental well-being is just as vital as caring for their physical well-being,” said TDCI Commissioner Carter Lawrence. “We are grateful for the opportunity to work with our colleagues at the Tennessee Department of Mental Health and Substance Abuse Services to help raise awareness of this important issue.”

“There is no difference between diabetes, hypertension or mental illness. These are all long-term illnesses that can be managed with the help of medical professionals,” said TDMHSAS Commissioner Marie Williams, LCSW. “Together with our partners at TDCI, we are excited to be working towards a future where all Tennesseans have easy access to the mental health services they need.

What you need to know about mental health coverage

  • Contact your health insurance company to find out if your policy covers mental health and addiction treatment.
  • If your plan does, then mental health treatment limits must equal physical health services. For example, if your co-payment is $30 for physical health services, it must be $30 for mental health services. If your plan covers 40 physical therapy visits, your plan must cover 40 behavioral health visits.
  • Treatment for these services may include therapy, behavioral counseling, inpatient and outpatient treatment, and medication management.
  • Your health plan should provide a directory of network professionals and facilities near you. If a provider does not accept insurance, contact your health insurance company and ask if you can file claims after receiving treatment to help cover some of the cost.

For additional guidance, TDCI has published this newsletter related to mental health services and created this consumer video to help explain mental health parity to consumers.

Coverage Questions or Concerns

Tennessee residents whose claim is denied or who believe their insurance company does not cover mental services at the same rate as physical services should file a complaint with TDCI.

TDCI’s Consumer Insurance Services team will mediate between the consumer and the insurance company to help find a solution. In 2021, Consumer Insurance Services recovered $8.2 million insurance companies for Tennesseans through these efforts.

To file a complaint, visit TDCI websiteselect File a complaint, then complete and submit the online complaint form.

For more information, call 615-741-2218 or 1-800-342-4029.

TDCI encourages anyone who has thoughts of self-harm to contact the Tennessee Crisis Line at 1-855-274-7471.

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