When you need help for depression, anxiety, or bipolar disorder, mental health insurance, the part of your health plan that pays for therapy, counseling, and psychiatric medications. Also known as behavioral health coverage, it’s supposed to be equal to physical health care—but in practice, it’s often harder to get. Many people think if their plan says "covers mental health," they’re safe. But that’s not always true. Insurance companies can limit how many therapy sessions you get, refuse to pay for certain medications, or make you jump through endless hoops just to get approved.
One big reason? prior authorization, a process where your doctor must get approval from your insurer before prescribing a treatment. For antidepressants like SSRIs or antipsychotics like risperidone, insurers often demand you try cheaper drugs first—even if those didn’t work before. And if your therapist is out-of-network? You might pay double—or get nothing at all. Then there’s the insurance denial appeal, the formal process to challenge a rejected claim. Most people give up after the first denial. But you don’t have to. A clear letter from your doctor, citing clinical guidelines and your history, can turn a "no" into a "yes."
It’s not just about therapy visits. Medications for mental health often face stricter rules than those for high blood pressure or diabetes. Some plans require step therapy for even common drugs like sertraline or fluoxetine. Others won’t cover newer treatments like esketamine nasal spray unless you’ve failed five other options. And if you’re on Medicaid or Medicare, coverage varies wildly by state. You might get 20 therapy sessions one year, then 10 the next. No warning. No explanation.
What you’ll find in the posts below are real, practical guides from people who’ve been through it. How to write a winning appeal letter. Why your insurer denied your prescription for bupropion. How to get your therapist covered even if they’re not in-network. And how to spot when a generic drug switch messes with your mood. These aren’t theory pieces. They’re battle-tested tips from patients, doctors, and advocates who’ve fought the system—and won.
