Mental Health Care
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:
- 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.
- 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.
- 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.
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.
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.
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.
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
Mental Health Association
Medi-Cal Mental Health Ombudsman
Problems and complaints