Skip Ribbon Commands
Skip to main content
Navigate Up
Sign In
Home > Mental Health Care

Mental Health Care

Man holding prescriptions talking to woman on couch

If you think you might benefit from mental health care services, talk to your doctor or call your plan directly to find out what’s offered.

 

 

Topics on this page:

 

Talk to your primary care doctor

  • Your doctor can prescribe some medicines, like drugs to treat anxiety and depression.
  • Your doctor can also refer you for counseling or other help if you need it.
  • Some plans have classes to help you deal with problems like anxiety, depression, and stress.

 

Talk to your plan

  • Ask what services are covered and how to get the service you need. Ask if you can get services without a referral from your doctor.  Ask what you have to pay.
  • Sometimes mental health services are provided through a separate behavioral health care plan. You can call this plan directly. The phone number may be on your membership card.

 

What health plans must cover

  • All plans must cover mental health care for major depression, bipolar (manic-depressive) disorder, panic disorder, anorexia or bulimia, obsessive-compulsive disorder, autism, schizophrenia, and schizoaffective disorder.
  • Plans must also cover children’s severe emotional disturbances and pervasive developmental disorders.
  • Plans must provide the same benefits for these mental health problems that it does for other health problems. This includes evaluation, testing, treatment, outpatient care, and hospital care. This is called mental health parity.
  • The co-pays or co-insurance must be the same as they are for other health problems.
  • If your plan covers prescription drugs, drugs for these mental health problems must also be covered.
  • Medi-Cal covers care for severe mental health problems.
  • Medicare covers some care for mental health problems. Ask your Medicare health plan what it covers.

 

Optional services

Health plans usually offer limited care for less serious problems. These services vary a lot from plan to plan. Ask your plan for more information.

Typical benefits include:

  • A limited number of visits to a counselor, psychologist, or psychiatrist.
  • A limited number of group counseling sessions.
  • Up to a month of hospital care, or a shorter stay with follow-up care.

 

Choosing a mental health care provider

A mental health specialist may be a social worker, family therapist, psychologist, or psychiatrist.

  • To find a provider, look in your plan’s provider directory or on its website.
  • Ask your plan to find you a mental health specialist who is qualified and experienced to treat your condition.
  • Ask which providers speak your language.
  • Ask your doctor and friends for recommendations.
  • Look for a provider you feel you can trust.
  • You can change to another mental health provider in your plan if you are not satisfied with the one you have.
  • If you do not think you are getting the right care, you can file a complaint.

 

New time limits on waiting for appointments

If you are in a managed care plan (HMO or certain PPOs overseen by the Department of Managed Health Care):

  • If you want to see a mental health care provider for a non-urgent appointment, you should get an appointment within 10 work days.
  • If you need an urgent care appointment that requires pre-approval, you should be able to get an appointment within 96 hours. If the urgent care appointment does not require pre-approval, you should be able to get an appointment within 48 hours.

 

Resources

OPA materials: Mental Health Care informational card

OPA materials: Mental Health "Trauma Drama" informational card

California Office of Patient Rights Advocacy Directory (includes contact information by County)

Disability Rights California

NAMI

Mental Health Association

Medi-Cal Mental Health Ombudsman

 

Related Topics

Problems and complaints

 

 

Health Plan Problems?

Call 1-888-466-2219

Find other resources...

Twitter

Facebook