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Home > A-Z Health Topics > Mental Health > Your rights > Getting and paying for health care

Getting and paying for health care

• What is private insurance?
• What if I don't have health insurance?

The high cost of health care makes treatment out of reach for many people. Those who do not have health insurance — more than 46 million Americans — often avoid treatment entirely, because costs can be staggering.

What is private insurance?

The majority of working Americans are covered under employer-provided health insurance plans. One type of plan is a standard indemnity policy, which gives people freedom to visit a health care provider of their choice and pay out of pocket for their treatment. The insurance plan reimburses members for some portion of the cost. The other common plan is a managed care plan. Under this plan, medically necessary care is provided in the most cost-effective, or least expensive, way available. Plan members must visit health care providers chosen by the managed care plan. Generally, a co-payment is charged to the patient, but sometimes all care received from providers within the plan is covered. Managed care companies provide services in many states for low-income Medicare and Medicaid beneficiaries. Both types of private health coverage may offer some coverage for mental health treatment. However, this treatment often is not paid for at the same rate as other health care costs.

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What if I don't have health insurance?

Resources for the uninsured with mental illness include:

• Community-based resources – Many communities have community mental health centers (CMHCs). These centers offer a range of mental health treatment and counseling services, usually at a reduced rate for low-income people. CMHCs generally require you to have a private insurance plan or to be a recipient of public assistance.
• Pastoral counseling – Your church or synagogue can put you in touch with a pastoral counseling program. Certified pastoral counselors, who are ministers in a recognized religious body, have advanced degrees in pastoral counseling, as well as professional counseling experience. Pastoral counseling is often provided on a sliding-scale fee basis.
• Self-help groups – Another option is to join a self-help or support group. Such groups give people a chance to learn about, talk about, and work on their common problems, such as alcoholism, substance abuse, depression, family issues, and relationships. Self-help groups are generally free and can be found in virtually every community in America. Many people find them to be effective.
• Public assistance – People with severe mental illness may be eligible for several forms of public assistance, both to meet the basic costs of living and to pay for health care. Examples of such programs are Social Security, Medicare, and Medicaid.
  • Social Security has two types of programs to help individuals with disabilities. Social Security Disability Insurance provides benefits for those individuals who have worked for a required length of time and have paid Social Security taxes. Supplemental Security Income provides benefits to individuals based on their economic needs.
  • Medicare is America's primary federal health insurance program for people who are 65 or older and for some with disabilities who are under 65. It provides basic protection for the cost of health care. Two programs exist to help people with low incomes receive benefits – the Qualified Medicare Beneficiary (QMB) and the Specified Low-Income Medicare Beneficiary (SLMB) programs.
  • Medicaid pays for some health care costs for America's poorest and most vulnerable people. More information about Medicaid and eligibility requirements is available at local welfare and medical assistance offices. Although there are certain federal requirements, each state also has its own rules and regulations for Medicaid.

Content last updated March 29, 2010.

Resources last updated March 29, 2010.

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