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FAQs2019-01-17T20:52:58+00:00

Project Description

Frequently Asked Questions

FAQs Relating to the East Central Region

Mental Health FAQs

What Is Mental Health?

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Over the course of your life, if you experience mental health problems, your thinking, mood, and behavior could be affected. Many factors contribute to mental health problems, including:

  • Biological factors, such as genes or brain chemistry
  • Life experiences, such as trauma or abuse
  • Family history of mental health problems

Mental health problems are common but help is available. People with mental health problems can get better and many recover completely.

Early Warning Signs

Not sure if you or someone you know is living with mental health problems? Experiencing one or more of the following feelings or behaviors can be an early warning sign of a problem:

  • Eating or sleeping too much or too little
  • Pulling away from people and usual activities
  • Having low or no energy
  • Feeling numb or like nothing matters
  • Having unexplained aches and pains
  • Feeling helpless or hopeless
  • Smoking, drinking, or using drugs more than usual
  • Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared
  • Yelling or fighting with family and friends
  • Experiencing severe mood swings that cause problems in relationships
  • Having persistent thoughts and memories you can’t get out of your head
  • Hearing voices or believing things that are not true
  • Thinking of harming yourself or others
  • Inability to perform daily tasks like taking care of your kids or getting to work or school

Learn more about specific mental health problems and where to find help.

Mental Health and Wellness

Positive mental health allows people to:

  • Realize their full potential
  • Cope with the stresses of life
  • Work productively
  • Make meaningful contributions to their communities

Ways to maintain positive mental health include:

  • Getting professional help if you need it
  • Connecting with others
  • Staying positive
  • Getting physically active
  • Helping others
  • Getting enough sleep
  • Developing coping skills

Learn More About Mental Health

Health Insurance and Mental Health Services

Do you have Insurance Questions about Mental Health or Addiction Services?

Help is available, if you have:

  • Been denied coverage
  • Reached a limit on your plan (such as copayments, deductibles, yearly visits, etc.)
  • Have an overly large copay or deductible

You may be protected by Mental Health and Substance Use Disorder Coverage Parity laws require most health plans to apply similar rules to mental health benefits as they do for medical/surgical benefits. Select your insurance type below for more about the protections that apply for you, and to get assistance information. There are Federal and State Agencies who can provide assistance.

Q: Does the Affordable Care Act require insurance plans to cover mental health benefits?

Answer: As of 2014, most individual and small group health insurance plans, including plans sold on the Marketplace are required to cover mental health and substance use disorder services. Medicaid Alternative Benefit Plans also must cover mental health and substance use disorder services. These plans must have coverage of essential health benefits, which include 10 categories of benefits as defined under the health care law. One of those categories is mental health and substance use disorder services. Another is rehabilitative and habilitative services. Additionally, these plans must comply with mental health and substance use parity requirements, as set forth in MHPAEA, meaning coverage for mental health and substance abuse services generally cannot be more restrictive than coverage for medical and surgical services.

Q: How do I find out if my health insurance plan is supposed to be covering mental health or substance use disorder services in parity with medical and surgical benefits? What do I do if I think my plan is not meeting parity requirements?

Answer: In general, for those in large employer plans, if mental health or substance use disorder services are offered, they are subject to the parity protections required under MHPAEA. And, as of 2014, for most small employer and individual plans, mental health and substance use disorder services must meet MHPAEA requirements.

If you have questions about your insurance plan, we recommend you first look at your plan’s enrollment materials, or any other information you have on the plan, to see what the coverage levels are for all benefits. Because of the Affordable Care Act, health insurers are required to provide you with an easy-to-understand summary about your benefits including mental health benefits, which should make it easier to see what your coverage is. More information also may be available via the Mental Health and Addiction Insurance Help consumer portal prototype and with your state Consumer Assistance Program (CAP). Additional, helpful information on what you can do to better understand the parity protections you have is available in Know your Rights: Parity for Mental Health and Substance Use Disorder Benefits.

Q: Does Medicaid cover mental health or substance use disorder services?

Answer: All state Medicaid programs provide some mental health services and some offer substance use disorder services to beneficiaries, and Children’s Health Insurance Program (CHIP) beneficiaries receive a full service array. These services often include counseling, therapy, medication management, social work services, peer supports, and substance use disorder treatment. While states determine which of these services to cover for adults, Medicaid and CHIP requires that children enrolled in Medicaid receive a wide range of medically necessary services, including mental health services. In addition, coverage for the new Medicaid adult expansion populations is required to include essential health benefits, including mental health and substance use disorder benefits, and must meet mental health and substance abuse parity requirements under MHPAEA in the same manner as health plans. For additional information on Medicaid and mental health and substance use disorder services, visit https://www.medicaid.gov/medicaid/benefits/bhs/index.html.

Q: Does Medicare cover mental health or substance use disorder services?

Answer: Yes, Medicare covers a wide range of mental health services.

Medicare Part A (Hospital Insurance) covers inpatient mental health care services you get in a hospital. Part A covers your room, meals, nursing care, and other related services and supplies.

Medicare Part B (Medical Insurance) helps cover mental health services that you would generally get outside of a hospital, including visits with a psychiatrist or other doctor, visits with a clinical psychologist or clinical social worker, and lab tests ordered by your doctor.

Medicare Part D (Prescription Drug ) helps cover drugs you may need to treat a mental health condition. Each Part D plan has its own list of covered drugs, known as formulary. Learn more about which plans cover various drugs.

If you get your Medicare benefits through a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan, check your plan’s membership materials or call the plan for details about how to get your mental health benefits.

If you get your Medicare benefits through traditional Medicare (not a Medicare Advantage plan) and want more information, visit Medicare and Your Mental Health Benefits (PDF | 879.44 KB). To see if a particular test, item or service is covered, please visit the Medicare Coverage Database.

Q. What can I do if I think I need mental health or substance use disorder services for myself or family members?

Here are three steps you can take right now:

  1. Learn more about how you, your friends, and your family can obtain health insurance coverage provided by Medicaid or CHIP or the Health Insurance Marketplaces by visiting HealthCare.gov.
  2. Find out more about how the law is expanding coverage of mental health and substance use disorder benefits and federal parity protections: http://aspe.hhs.gov/health/reports/2013/mental/rb_mental.cfm
  3. Find help in your area with the Behavioral Health Treatment Services Locator or the Find a Health Center.

Q: What is the Health Insurance Marketplace?

The Health Insurance Marketplace is designed to make buying health coverage easier and more affordable. The Marketplace allows individuals to compare health plans, get answers to questions, find out if they are eligible for tax credits to help pay for private insurance or health programs like the Children’s Health Insurance Program (CHIP), and enroll in a health plan that meets their needs. The Marketplace Can Help You:

  • Look for and compare private health plans.
  • Get answers to questions about your health coverage options.
  • Get reduced costs, if you’re eligible.
  • Enroll in a health plan that meets your needs.

Learn more at HealthCare.gov.

Last Updated: 03/19/2018

For People With Mental Health Problems

If you have, or believe you may have, mental health problem, it can be helpful to talk about these issues with others. It can be scary to reach out for help, but it is often the first step to helping you heal, grow, and recover.

Having a good support system and engaging with trustworthy people are key elements to successfully talking about your own mental health.

Build Your Support System

Find someone—such as a parent, family member, teacher, faith leader, health care provider or other trusted individual, who:

  • Gives good advice when you want and ask for it; assists you in taking action that will help
  • Likes, respects, and trusts you and who you like, respect, and trust, too
  • Allows you the space to change, grow, make decisions, and even make mistakes
  • Listens to you and shares with you, both the good and bad times
  • Respects your need for confidentiality so you can tell him or her anything
  • Lets you freely express your feelings and emotions without judging, teasing, or criticizing
  • Works with you to figure out what to do the next time a difficult situation comes up
  • Has your best interest in mind

Find a Peer Group

Find a group of people with mental health problems similar to yours. Peer support relationships can positively affect individual recovery because:

  • People who have common life experiences have a unique ability to help each other based on a shared history and a deep understanding that may go beyond what exists in other relationships
  • People offer their experiences, strengths, and hopes to peers, which allows for natural evolution of personal growth, wellness promotion, and recovery
  • Peers can be very supportive since they have “been there” and serve as living examples that individuals can and do recover from mental health problems
  • Peers also serve as advocates and support others who may experience discrimination and prejudice

You may want to start or join a self-help or peer support group. National organizations across the country have peer support networks and peer advocates. Find an organization that can help you connect with peer groups and other peer support.

Participate in Your Treatment Decisions

It’s also important for you to be educated, informed, and engaged about your own mental health.

Get involved in your treatment through shared decision making. Participate fully with your mental health provider and make informed treatment decisions together. Participating fully in shared decision making includes:

  • Recognizing a decision needs to be made
  • Identifying partners in the process as equals
  • Stating options as equal
  • Exploring understanding and expectations
  • Identifying preferences
  • Negotiating options/concordance
  • Sharing decisions
  • Arranging follow-up to evaluate decision-making outcomes

Learn more about shared decision making.

Develop a Recovery Plan

Recovery is a process of change where individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Studies show that most people with mental health problems get better, and many recover completely.

You may want to develop a written recovery plan. Recovery plans:

  • Enable you to identify goals for achieving wellness
  • Specify what you can do to reach those goals
  • Can be daily activities as well as longer term goals
  • Track your mental health problem
  • Identify triggers or other stressful events that can make you feel worse, and help you learn how to manage them

You can develop these plans with family members and other supporters. Learn more about recovery.

For Young People Looking for Help

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Mental health problems don’t only affect adults. Children, teens and young adults can have mental health problems, too. In fact, three out of four people with mental health problems showed signs before they were 24 years old.

If you’re thinking about harming yourself get help immediately. You can call 911 or the National Suicide Prevention Line at 1-800-273-TALK (8255).

What Does “Mental Health Problem” Mean?

Are you having trouble doing the things you like to do or need to do because of how you feel—like going to school, work or hanging out with friends?

Are you having a rough day? Have you been feeling down for a while? Everyone goes through tough times, and no matter how long you’ve had something on your mind, it’s important that you talk to someone about it.

Talk to your parents or a trusted adult if you experience any of these things:

  • Can’t eat or sleep
  • Can’t perform daily tasks like going to school
  • Don’t want to hang out with your friends or family
  • Don’t want to do things you usually enjoy
  • Fight a lot with family and friends
  • Feel like you can’t control your emotions and it’s affecting your relationships with your family and friends
  • Have low or no energy
  • Feel hopeless
  • Feel numb or like nothing matters
  • Can’t stop thinking about certain things or memories
  • Feel confused, forgetful, edgy, angry, upset, worried, or scared
  • Want to harm yourself or others
  • Have random aches and pains
  • Smoke, drink, or use drugs
  • Hear voices

Learn more about specific mental health problems.

Where Can I Get Help?

You are not alone. Lots of people have been where you are or are there right now. But there are also lots of people who want to help you.

If you’re thinking about harming yourself get help immediately. You can call 911 or The Iowa Helpline at 1-855-800-1239.

Another way to get help is by talking to someone you trust. This could be a parent, family member, teacher, school counselor, spiritual leader or another trusted adult, who:

  • Gives good advice when you want and ask for it
  • Respects your need for privacy so you can tell him or her anything
  • Lets you talk freely about your feelings and emotions without judging, teasing, or criticizing
  • Helps you figure out what to do the next time a difficult situation comes up

Learn More About Young People and Mental Health