Is mental health treatment covered by health insurance?

 

Mental health treatment is available in many different formats. The treatment you need will depend on the severity of your condition. Essentially the earlier you start your treatment the better. Early intervention is a key element of your recovery.

A recent survey by the charity Mind has found that the coronavirus lock-down has had a detrimental effect on mental health. According to their survey of 16,500 people, 22% of adults who had no previous experience of poor mental health now say that their mental health is poor or very poor. For full details of the survey and its results, please follow the link below:

https://www.mind.org.uk/news-campaigns/news/uk-government-must-urgently-plan-for-recovery-from-coronavirus-mental-health-crisis-says-mind/

Health insurance in the UK tends to be a modular product and you can choose whether or not you include cover for mental health. Some providers will even offer different levels of mental health cover for their members.

What type of conditions are we referring to when we say mental health?

There are a number of medical conditions that come under the banner of mental health. These include:

  • Anxiety and panic attacks
  • Bipolar disorder
  • Depression
  • Drug and alcohol dependency
  • Eating problems
  • Obsessive compulsive disorder (OCD)
  • Panic attacks
  • Paranoia
  • Phobias
  • Post-traumatic stress disorder (PTSD)
  • Schizophrenia
  • Self-Harm

If you have a private medical insurance policy that covers mental health conditions you can then access private treatment. The 2020 coronavirus pandemic has affected the face to face availability of many private treatments however, video and telephone consultation options have been extended.

Which insurance companies offer cover for mental health?

There are many private medical insurance providers in the UK and our panel of providers who offer cover for mental health include:

Aviva ∙ AXA PPP ∙ Bupa ∙ Cigna ∙ The Exeter ∙ Freedom Health Insurance ∙ General & Medical ∙ The PHC ∙ Vitality Health

Let’s have a look at one of them in more detail:

The PHC are a smaller insurer who offer an excellent product that is underwritten by AXA PPP. They work with specialist health insurance intermediaries only rather than within the direct market place and therefore you may never even have heard of them. The do provide a great mix of flexibility and outstanding customer service levels along with the backing of a global giant in AXA PPP. An excellent option for business health insurance customers.

Mental health cover from The PHC

If you choose to include mental health cover in your company private medical insurance, what does this give your employees access to?

Plan In-Patients Out-patients
Level 1 Yes Yes
Level 2 Yes Yes: £1500 limit
Level 3 Yes Yes: £1000 limit
Level 4 No No

 

Well-being services also available from PHC include:

  • Counselling and Support service
  • Health at Hand
  • Active +
  • Stronger Minds
  • Dedicated Nurses for people with cancer and heart conditions
  • Managers support package

Although the PHC plan level 4 excludes cover for mental health, this is a budget plan and therefore the premiums are far lower than level 1 cover. If you do not want cover for mental health to be included on your policy you would also have the option to exclude this on the other plans from PHC, level 1 to 3.

Do private medical insurers exclude any specific conditions relating to mental health?

Each insurance provider will publish their own terms and conditions which will include clarification about any general exclusions on your policy. Although the prospect of reading insurance literature does not excite the mass population it is a really good idea to ensure that you know what is or is not covered by your policy.

General exclusions could include:

  • Mental health conditions that you had prior to the start of your policy
  • Autism and ADHD
  • Learning or developmental disorders
  • Alcohol or drug/substance abuse*
  • Psychotherapy relating to gender re-assignment
  • Suicide attempt
  • Self-harm
  • Sleep disorders

The above list is not exhaustive and will vary depending on which insurer your policy is with. *Bupa as an example have lifted their exclusion in relation to addiction (from June 2019) and will fund one addiction treatment programme per membership lifetime. This is certainly great news and a bold move in the right direction for the treatment of mental health disorders.

What type of treatments will private health insurance give you access to for the treatment of mental health conditions?

If you have chosen to include full cover for mental health treatment this should provide in-patient treatment for the more serious mental health conditions or out-patients treatment where your condition does not need intensive therapy.

Some providers will allow you direct access to their mental health services without the requirement of a GP referral. Providing your symptoms are not related to an exclusion on your policy or the general exclusions within their terms and conditions they will be able to direct you to the mental health specialist that is appropriate for your condition.

Direct access to mental health treatment really has been increased in 2020 due to the COVID19 pandemic. Insurance providers know that it is far more difficult to access primary care at this time and have therefore expanded their online and telephone services.

Your policy may give you access to:

  • Talking therapies
  • CBT
  • Medication
  • Psychotherapists
  • Psychology consultations
  • Psychiatry consultations
  • Counselling and support helplines
  • Mental Health apps such as Big White Wall or Thrive

Will my private medical insurance cover me for psychiatric treatment in any hospital?

There are a number of specialist psychiatric facilities within the UK.  Your access to them would depend on the hospital list you have chosen (where applicable as not all health insurers have multiple hospital lists).

As an example is you were insured with Vitality Health and needed to go to The Nightingale Hospital in London then you would need to be insured on the Vitality Health London Care hospital list. Cover for this hospital would not be available on the Countrywide or Local Care list.

All hospitals in the UK have to be registered with the Care Quality Commission. It is always a good idea that you check the rating of the hospital or facility you are considering for treatment. In the above example, The Nightingale hospital is rated as GOOD following the inspection in March 2019:

https://www.cqc.org.uk/location/1-109980250

You may not need in-patient or day patient treatment and prefer to visit your local private hospital. Most will offer mental health and psychiatric services. You may also find mental health professionals who work from their own private clinic.

In Chelmsford for example we have the specialist mental health facilities at The Priory Hospital. Although the coronavirus pandemic has affected the availability of face to face out-patient and day-patient treatment, they are still able to offer assessments and therapy on a remote basis. For people who need in-patient treatment, this is still available across the network of Priory hospitals.

Would it be easier to self-fund mental health treatment?

The option to self-fund your treatment for mental health is always available. You can self-fund even if you have private medical insurance in place. The over-riding factor when it comes to the question of self-funding is normally the cost of treatment.

If you were looking at a consultation then 6 sessions of CBT the cost of treatment would be minimal. You could choose to self-fund the treatment in this instance to avoid making a claim on your policy. This way, the renewal premium offered would not have a claims related adjustment. Your renewal offer would include the standard increase rather than becoming claims loaded.

On the flip side, if you were suffering with a severe episode involving mental health and needed to have intensive treatment as an in-patient the costs could rapidly grow.  In this scenario, if you have private medical insurance that covers you for mental health treatment then you would really need to make a claim for treatment of this type. Mental health treatment can run into thousands of pounds. The claims adjustment on your renewal offer is unlikely to ever reach the cost of the treatment that you have had.

Do Health Cash Plans offer any type of mental health cover?

A health cash plan is not private medical insurance and predominantly offers cash back for everyday healthcare costs. These treatments include dental, optical and physiotherapy type treatments. A cash plan is far cheaper than private medical insurance but do they offer any help at all in relation to mental health conditions? There are many providers of health cash plans in the UK market. Health cash plans are available on both an individual and company basis.

The Classic cash plan from Healthshield (Company scheme)

If we look at the Classic plan from Healthshield as an example (which is available for companies with 3 or more employees) they automatically have access to My Counselling & Stress Intervention.

  • My Counselling is a 24/7 counselling and support helpline that can offer support for stress, anxiety, bereavement, financial concerns and family issues.
  • Stress Intervention is a work related stress support programme

There is an annual limit for specialist consultations which could be used to see a mental health specialist. The higher the cash plan level you choose, the higher the cash back you would be entitled too.

Within the Healthshield cash plan there is a health and wellbeing benefit. There are many alternative therapies included within this benefit section which could be used to help people suffering with mental health issues including counselling and CBT.

Employers can also (for a small additional monthly fee) add an employee assistance programme which again is designed to give additional support to your staff.

Healthshield have also introduced a whole range of occupational health solutions which again could be key in ensuring that employees have the best support when it comes to mental health.

Health cash plans also carry general exclusions and regardless which cash plan you choose for your staff, you can check to see what exactly is covered prior to buying a policy.

With all of the information provided, you can see there is a huge range of mental health options within the private healthcare sector. If you would like to know more information as an individual or on a company basis, the team at SMP Healthcare would be happy to help you further.

We want all of our clients to know exactly what they have cover for and if mental health is a priority for you then let us guide you to the policies where mental health is a key element of cover.

You can contact us via:

Email: enquiries@smphealthcare.com

Telephone: 01245 929129 or 0800 047 0127