HEALTH INSURANCE COVERS YOUR

• In 2022, Georgia passed a law ensuring public and private health insurance plans cover behavioral (mental) health at the same level as physical health.
  
  
• Law Goal: Help Georgians get affordable treatment for mental health and substance use disorders.

• Mental illnesses are among the most common health conditions in the United States.
  
  
• 1 in 5 American adults experience some form of mental illness each year.
  
  
• However, even some of the most serious mental health conditions can be treated, allowing people to thrive and live meaningful lives. 

• In Georgia, it’s the law that if you have health insurance (public or private), you’re entitled to mental health coverage on par with physical health coverage. 
  
  
• Insurance companies can no longer deny coverage for medically necessary behavioral health treatment. 
  
  
• Early intervention may prevent a future crisis. 
  
  
• You can now seek help for you or your family without fear of being denied. 

1. Higher payments: Your payments for mental health services are higher than for your primary care doctor.
   
   
2. Limitations: You are limited in how many times you can see a mental health care provider, but no such limits for physical health care.
   
   
3. Higher costs for medicine: You pay more for prescription medications to treat mental health than for physical health.
   
   
4. Needing permission: Your insurance company requires permission to continue mental health treatments, but not physical health treatments.
   
   
5. Forced to take less expensive treatment: Your insurance company requires that you try a less expensive treatment option before covering the treatment your mental health provider recommended.
   
   
6. Separate deductible: Your insurance plan has a separate deductible for mental health services.

Not receiving the mental health coverage you need? Follow these steps:

• Identify your type of insurance plan: employer-sponsored, individual, Medicaid, or government insurance.
• Gather your coverage documents, including insurance ID card and other insurance paperwork. Have insurance denial letter or bill for your mental health treatment.
• Ask for a letter of support from your mental health provider that indicates reasons for the requested care to have on hand for your appeal.
• Call the phone number on the back of your insurance ID card and say you would like to appeal a denial of coverage. Be sure to record your phone call.
• You may also wish to write an appeal letter to send to your insurer.

Here is a sample appeal letter.

Were you able to resolve your complaint by reaching out to your insurer?

YES: No further action needed.

NO: Proceed to Step 2 below. You can submit a complaint to one of the state agencies that oversees your insurance plan. This helps the state agencies monitor and ensure that Georgians are getting the mental health care coverage required by law.

• If you have health insurance through your job or family member, or selected your insurance yourself: File a complaint through the Georgia Department of Insurance online consumer complaints portal.

• If you have insurance through Medicaid, PeachCare for Kids, or the State Health Benefit Plan (for state government employees): File a complaint through the Georgia Department of Community Health online mental health parity complaint form.

For more information on health insurance complaints and appeals, please consult the ‘Health Insurance Appeals Guide’ available from The Kennedy Forum and the National Alliance on Mental Illness (NAMI).

Contact the 988 Suicide and Crisis Lifeline if you are experiencing mental health-related distress or are worried about a loved one who may need crisis support.

Call or text 988 or chat at 988lifeline.org

The Carter Center

Georgians for a Healthy Future

Georgia Parity Collaborative

This campaign is made possible thanks to generous funding from the Arthur M. Blank Family Foundation.

© 2023 THE CARTER CENTER. ALL RIGHTS RESERVED. 

PRIVACY POLICY