Getting the Most Out of Health Insurance for Mental and Behavioral Health Care

Thrive • December 1, 2021

As a new year approaches, many individuals have the opportunity to participate in Open Enrollment. During this time, it can be beneficial to understand your access to mental and behavioral health care coverage so you can make informed decisions that prioritize your well-being. Whether you are unsure of what mental and behavioral benefits your current provider offers or are actively trying to obtain coverage that includes these types of care, below is some helpful information about insurance to keep in mind.

MENTAL AND BEHAVIORAL HEALTH INSURANCE STANDARDS

Mental and behavioral health conditions can disrupt the intricate relationship between the mind, body, and spirit, resulting in significant impacts to overall well-being. So, conditions involving the mind and behavior patterns require specialized care from experts who grasp their complex nature. Fortunately, mental and behavioral health care are considered essential health benefits by the Affordable Care Act (ACA). This means that to be in accordance with the ACA, health insurance plans must cover mental and behavioral health care without spending limits. Furthermore, ACA-approved plans or “Marketplace” plans must also cover pre-existing mental and behavioral health conditions.

Marketplace plans must include coverage of:

Behavioral therapy: Works to change unhealthy behavior patterns.
Cognitive Behavioral Therapy (CBT): Teaches individuals to practice mindful awareness of unhelpful thought patterns and reframe them in a more positive way.
Psychotherapy: Focuses on a broad range of mental and behavioral health conditions, such as anxiety, depression, and bipolar disorder.
Counseling services: Targets specific struggles, such as stress management or addiction over a shorter period of time than psychotherapy.
Group therapy: Allows individuals to be a part of a therapeutic group of people experiencing similar obstacles guided by a mental health professional.
Treatments for substance use: May include sober living, outpatient, and inpatient treatment programs.
Prescription medications: Can be used alongside therapy to aid mental and behavioral health challenges.
Online tools: May include virtual care options and healthcare provider directories.

Understanding Parity and Common Breaches

In addition to these services, Marketplace plans must treat medical and mental health benefits with parity. As such, limits on mental health coverage cannot be more restrictive than limits on medical coverage.

Unfortunately, parity is often violated by insurance plans. Understanding common breaches can help prepare you to advocate for your mental and behavioral health treatment with your insurance provider so you can receive the care you deserve.

Below are just a few examples of such breaches:

A plan allows fewer visits for mental health care than for other types of health care.
A plan’s out-of-pocket costs for mental health care are higher than for different types of health care.
A plan requires prior approval for mental health care but not for other types of health care.
A plan won’t pay for mental health treatment that your mental health provider says you need.
You cannot find an in-network mental health provider or schedule a timely appointment.

If you believe your plan is violating parity, you can file an insurance complaint and appeal care denials. The National Alliance on Mental Illness (NAMI) offers additional guidance for navigating health insurance and advocating for your needs.

ASK THE RIGHT QUESTIONS

If you’re uncertain about your current mental and behavioral health care benefits or shopping for new health insurance, you may want to ask the insurance provider some of the following questions:

Is my mental health insurance provider different from my medical insurance provider?
Do my benefits include coverage of outpatient and inpatient mental and behavioral health services?
Do my benefits include coverage of nutrition therapy and occupational therapy?
Are there any limitations to my mental and behavioral health coverage? For example, some insurance plans may limit the number of visits to certain health care providers.
Are there any exclusions to my mental and behavioral health coverage? For example, some plans will only cover the treatment of certain diagnoses.
Does my insurance require a referral or preauthorization for mental and behavioral health coverage?

Asking the right questions upfront can empower you with the knowledge necessary to take control of your mental and behavioral health care.

SUPPLEMENTARY MENTAL AND BEHAVIORAL HEALTH INSURANCE FEATURES

If you’re in the market for new health insurance, you may also consider whether certain mental and behavioral health care services are offered, such as:

An emotional support line
Mental health virtual care (also known as telemedicine)
Access to mental health services without referrals
Online mental health screening tools
A directory of in-network therapists and psychiatrists

With 52.9 million U.S adults having experienced a mental illness in 2020 , services like the ones above are becoming more commonplace, making support for mental and behavioral health concerns more well-rounded, accessible, and financially feasible.

HELP WITH HEALTH INSURANCE AT THRIVE

Health insurance can be complicated, but Thrive Wellness can help make it simpler for you. Thrive is in-network with many major health insurance providers and also has the ability to secure single case agreements. Additionally, Thrive’s business office can work with you and your insurance provider to understand your benefits and advocate for your care while doing our best to obtain coverage for your treatment. Get in touch with us to begin your mental or behavioral health healing journey.

The post Getting the Most Out of Health Insurance for Mental and Behavioral Health Care first appeared on Thrive Wellness.

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Is It OCD or an Eating Disorder? What Parents Need to Know

July 17, 2025

As a parent, noticing alarming behaviors around food or routines in your child can raise some important questions. You might be asking yourself, “Is this an eating disorder, obsessive-compulsive disorder (OCD), or something else entirely?” Understanding the signs and differences between these disorders is key to getting your child effective, timely treatment. In this blog, we’ll break down the overlap between OCD and eating disorders, what signs to watch for, and how to get professional help. If you're a parent wondering “Is my child’s eating disorder actually OCD?” or “OCD vs eating disorder in teens,” know that you’re not alone and you’re in the right place to find specialized care for your child. What Is OCD? Obsessive-Compulsive Disorder (OCD) is a mental health condition where unwanted thoughts (obsessions) cause anxiety, leading to repetitive behaviors (compulsions) intended to ease that anxiety. OCD can be focused on any subject. Common obsessions include contamination, perfectionism, scrupulosity, and harm, but sometimes, the content of obsessions can be focused on food, body image, or weight. What Is an Eating Disorder? Eating disorders , like anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID) involve disturbed eating behaviors and intense concerns about body weight or shape. These conditions go beyond dieting or “picky eating” and can become life-threatening without professional intervention. The Overlap: Why It Can Be Confusing OCD and eating disorders often share similar symptoms : Ritualistic eating (e.g., needing to eat foods in a certain order or at a certain time) Rigid rules about food (like only eating certain food groups or certain amounts of food) Excessive checking (like weighing food or body or repeated checking of expiration dates or thorough cooking) Avoidance behaviors ( like avoiding carbs, fats, or other food groups or avoiding places or objects that can trigger obsessions) Distress when routines are disrupted (either around mealtimes or exercise routines) So, How Can You Tell the Difference? Use the following chart to compare and contrast symptoms of OCD and eating disorders.

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Navigating Coming Out: Emotional Wellness Tips for Every Stage

June 4, 2025

Coming out is a deeply personal, courageous, and in many cases, life-changing act. Whether you're sharing your sexual orientation or gender identity, coming out is about embracing authenticity and sharing an essential part of who you are. During the process of coming out, prioritizing your mental health at every stage is crucial. In this blog, we'll discuss insights and strategies to support your mental health before, during, and after coming out. Wherever you are in your journey, know that your experience is valid and you are not alone. Understanding the Mental Impact of Coming Out Coming out can bring about a lot of big feelings, including fear, relief, joy, anxiety, grief, and hope, sometimes all at once. Know that heightened emotions during this time are completely normal. Sharing such an integral part of yourself with the world can feel intense, but even with the ups and downs, being authentically you is worth it. Because LGBTQIA+ individuals face added mental health burdens due to stigma and discrimination, taking care of yourself during this time is more important than ever. You might experience increased anxiety, mental exhaustion, or avoidance ahead of coming out, so don’t be afraid to reach out for support. At its core, coming out is about authentic self-expression and showing your truest self, which can feel both exciting and scary at the same time . The self-acceptance and community gained from coming out is a vital part of finding long-term strength and joy. Still, it’s okay if you feel uncertain or conflicted, and these feelings are just part of the process. Before Coming Out: Emotional Preparation Coming out starts with reflection. Remember that there’s no rush when it comes to figuring out who you are. It’s okay to take time to understand your identity and what coming out might mean for you. Here are a few questions to consider: What do I hope to gain by coming out? Who feels emotionally safe to talk to? What are my fears, and how can I manage them? Mental wellness tips before coming out: Journaling can help you better understand your feelings and fears and explore different ways to share your truth. Talking through your feelings and different scenarios with a therapist , especially one who is LGBTQIA+ affirming, can help you to feel more supported and ready to come out. Practice grounding techniques like deep breathing, meditation, or visualization to ease anxiety ahead of sharing your identity. Helpful resources for coming out include: Trevor Project Lifeline (1-866-488-7386) TrevorSpace (an online community for LGBTQIA+ youth) OurCenter (a local community center for the LGBTQIA+ community in Reno) During the Coming Out Process: Staying Grounded The act of coming out can feel intimidating, as you’re sharing such a vital part of who you are. You might experience fear, panic, or doubt. While these feelings are real, know that you don’t have to navigate them alone. Tips for emotional resilience: Practice conversations ahead of time with a therapist or supportive friend so you feel ready when the time comes to share. Choose a time and place where you feel safe and in control. Use affirming statements, like, “I deserve to be loved for who I am.” Coping with negative responses: Set emotional boundaries with people who aren’t supportive. Create an emotional safety plan: know who you can call, where you can go, and what can help soothe you in moments of distress. After Coming Out: Processing and Healing Coming out, no matter how it went, deserves to be celebrated. An act of strength and authenticity like coming out is no small feat, so be proud of yourself for sharing who you are. Even so, the emotional aftermath can be complicated. You might feel joy and empowerment or loss and grief, especially if relationships shift. Healing strategies: Acknowledge your courage . Even difficult conversations are acts of strength. Rebuild your safety if you've experienced rejection. This might mean changing your environment or seeking new support systems. Release guilt or shame. Being who you are is never something you should feel ashamed or guilty for. Support networks can make a huge difference. Seek out different forms of support like: LGBTQIA+ support groups (in-person or online) Peer mentors or community leaders Allies, friends, or family who affirm and respect your identity Therapeutic options to deal with stress, grief, or isolation associated with coming out: EMDR (Eye Movement Desensitization and Reprocessing) can help process trauma. Narrative therapy helps you rewrite your story in your own empowering voice. Coming Out More Than Once: Navigating the Long Game Coming out isn’t just a single milestone, it’s a recurring process. You might come out again and again: to a healthcare provider, a neighbor, a partner, or a friend. It can feel exhausting or unfair to have to come out more than once, but each time, you’ll continue to find more strength, confidence, and understanding for yourself. Other tips for coming out: Focus on cultivating a strong inner identity that doesn’t rely on external validation. You know who you are, and you don’t need to prove yourself to anyone. Create a personal toolkit of coping and grounding strategies to deal with stress or burn-out associated with coming out. Thrive Wellness offers a free breathing exercise guide to help relieve anxiety and calm the nervous system. Download it here . Find affirmation and support through community. This can look like finding a chosen family, looking up to queer role models, attending events that celebrate the LGBTQIA+ community and its history, and working on embracing authenticity and having pride in who you are. Remember, there’s no one-size-fits-all approach to coming out, and it’s never too late to share who you are. Whether you're preparing to come out, in the midst of sharing your truth, or processing what came after, know that you are worthy of love, safety, and joy. Your truth is worth celebrating, today and everyday! For support during the coming out process and beyond, reach out to our team of affirming, inclusive, and compassionate mental and physical health care providers. We're here for you.