Mental Health Care and Your Benefits Accounts

With one in five U.S. adults experiencing some form of mental illness in any given year, the need for mental health care impacts many families.

Yet, according to the National Alliance of Mental Illness (NAMI), 55 percent of adults and 49 percent of children ages 6-17 with a mental illness don’t receive mental health care services. And that affects all of us, as NAMI estimates that untreated mental illness costs the U.S. economy almost $300 billion annually in lost productivity, absenteeism, turnover and increased medical and disability costs.

The problem isn’t so much with the prevalence or the cost of mental illness. It’s the fact that so many of those who have it or are experiencing it are not receiving mental health care treatment. Why don’t people suffering from mental illness receive the help they need?

Mental Health Stigma

One reason people do not get help has to do with mental health stigmas. One of these is social stigma, which consists of prejudiced attitudes and negative thinking that some have about mental illness. Another is self-perceived stigma, which is internalized, but can affect mentally ill people just as much as social stigma. Both cause the sufferer to feel shame or guilt about circumstances that are beyond their control.

However, for many people the biggest reason for not getting help is the cost of mental health care. According to the Substance Abuse and Mental Health Services Administration (SAMSHA), half of all mental illness patients rank treatment costs as the primary reason they don’t seek help.

Paying for Mental Health Treatment

Having a consumer-directed healthcare (CDH) account can help with costs. A CDH account is a type of medical savings account that helps consumers pay for eligible medical expenses with pre-tax dollars. Consumer-directed healthcare accounts give participants more control over their healthcare dollars. People may pick and choose which qualified expenses to spend their money on, including many mental health treatments.

Three of the most common CDH accounts include Flexible Spending Accounts (FSA), Health Savings Accounts (HSA), and Health Reimbursement Arrangements (HRA). FSAs and HRAs are sponsored exclusively by employers as part of their overall benefits plan. With an HSA, a person enrolled in a qualified high deductible health plan (HDHP) can open the account through their employer or another institution, such as a bank. Learn more about the differences between an HRA and HSA.

Behavioral Health Services: What is Covered

According to IRS Publication 502, “Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body.” For those living with mental illness, FSAs and HSAs cover many different types of behavioral health services, including:

Prescription medications

Many mental illnesses can be treated with prescription medicines. These include depression, anxiety, obsessive/compulsive and eating disorders, and bipolar disorder.

Despite the stigmas surrounding mental health that deter people from talking openly about these issues, it is estimated that 1 out of every 10 Americans currently takes some kind of anti-depressant medication to help manage their condition. As long as they are prescribed by a licensed doctor, the cost of these medications can be paid for with your benefits account.

Keep in mind that most types of anti-depressant medications have been around long enough that they are available in generic form. Generic prescriptions generally cost less than brand name versions. Be sure to talk to your healthcare provider about using generic medications.

Psychiatric care

Although mental health problems are often first diagnosed by a primary care provider, many types of mental illness require specialized care. In addition to prescriptions, psychiatric care may be part of a person’s treatment plan.

Psychiatrists are typically the ones who prescribe anti-depressants and other medications, as they have more expertise in treating mental illness. They may also provide services such as psychotherapy. Psychiatric care, psychotherapy and related treatments are IRS-approved behavioral health services.

Clinical psychologists and counselors

Mental health patients may also seek help from a psychologist, counselor, or social worker. Since these specialists are not medical doctors, they cannot prescribe medications. However, they can work with the patient using different modes of behavioral or cognitive therapies, and in the case of psychologists, can administer psychological tests.

Treatments provided by these specialists are eligible for FSA or HSA reimbursement if received for specific types of mental illness. However, receiving therapy for general improvement of mental health is not a qualified CDH behavioral health service and can’t be paid for with a CDH account.

Specialized treatments

In addition to prescription medications and office-based therapy programs (whether with primary care physicians or specialists), mental health patients can also seek help through specialized treatments such as rehabilitation centers for addiction or other medical problems.

With your employer-sponsored healthcare benefit account, in- and out-patient treatment for alcoholism, drug addiction and other types of substance abuse qualifies as eligible behavioral health services. This includes the cost of meals and lodging for in-patient treatment, as well as transportation expenses for attending meetings of Alcoholics Anonymous, Narcotics Anonymous, or similar recovery groups.

HSA funds can also be used to pay for other types of therapy programs. Physical, occupational, and speech therapies help individuals return to their normal lives after an accident, surgery, or some other type of life-disrupting event.

Acupuncture and hypnosis

Did you know that acupuncture and hypnosis are approved for payment with a CDH account? Acupuncture is often used to treat depression, eating disorders and other types of mental illness. In addition, with a Letter of Medical Necessity from a physician, mental disorders treated with hypnosis may be paid for with a healthcare benefits account.

Getting treatment today

If you or a dependent suffer from mental illness, you need and deserve to receive appropriate treatment. Seeking care for mental health can be more affordable when you have an FSA or HSA. Many treatments and medications fall under the IRS guidelines for eligible expenses.

Talk to your HR about your company’s benefit plan, and see if an FSA or HSA (or HRA) is right for you.