Rejected by your insurance company for mental health treatment? Don’t be discouraged.

There is an old joke about an insurance boss who is happy with his employees and says, “You worked very hard this year. As a reward, I’ll give everyone a check for $5,000. If you continue working at the same level next year, I’ll sign those checks.”

When it comes to mental health, this joke often feels all too true. 

And it’s certainly no laughing matter.

Mental health insurance coverage

If you search mental health insurance coverage, you will find that if “mental health is included in the plan, then the insurance company is responsible to uphold federal parity law.” This means that deductibles, co-payments, out-of-pocket maximums, and prescription benefits must be reimbursed.

But it hasn’t always been this way. In fact, these are from the Mental Health Parity and Addiction Equity Act (MHPAEA), which, although passed in 2008, was only amended in 2024.

And the reason it was amended is due to people like Joe Feldman. 

Cover My Mental Health

Joe advocates for mental health coverage via the organization he founded called Cover My Mental Health. His mental health care advocacy work began when his child’s residential care was denied by the family’s insurer – a situation he found was exceptionally common when it comes to mental health.

One of Joe’s children was experiencing extreme difficulties with mental health and the family made the difficult decision to make use of a residential facility. 

As Joe says: 

“When one of our kids was in high school, troubles were brewing. We tried to get help with something that was related to mental health, broadly speaking. On the advice of a psychiatrist, we decided to take a significant step, and that was a residential program. The belief was that the kid wasn’t going to be successful with local care.”

With a self-admitted naivety, Joe thought that their insurance would cover the cost, only to find that it came back denied – on the grounds that care was deemed “not medically necessary”. 

“It hadn’t crossed my mind that a decision about care for a member of our family would be called into question by our insurance company,” he says.

A federal lawsuit

Joe recognized the injustice of this as his child genuinely needed support. He decided to appeal. 

In what was undoubtedly a difficult time for the family, Joe fought that decision and was eventually successful, winning a federal lawsuit and getting the care that his child required. 

That could have been the end of the story for Joe. He got what he needed for his family. And yet, he understood that other families shouldn’t have to go through the same difficult process to get access to life-altering support.

As a result, he decided to continue his advocacy, which led him to found a nonprofit where he can share his knowledge. Now, he speaks across the country on the issue of insurance denial and obtaining mental and behavioral health care that is needed. 

He has become one of the principal voices on the issue of insurance denial and obtaining mental and behavioral health care that is needed, having served on the Kennedy Forum Illinois and regularly speaking across the country.

Real, actionable advice and resources

Joe’s website provides swathes of advice and resources for anyone who finds themself in a similar situation. Much of it is based on his own personal experience and is based on key moments that worked in his favor. 

For example, he talks about how important it is to get what’s known as a “medical necessity letter" from your psychiatrist. 

“We won the lawsuit because of the psychiatrist,” Joe says, as he had that document with service as “crucial evidence” in their favor. However, he found that the writing of these letters is not standard. 

In fact, he discovered that many psychiatrists and therapists aren’t even aware how impactful these documents can be. This led to Joe writing an article about medical necessity letters, alongside his litigator and a clinician, to make more people aware of this. 

And there is so much more on the website: templates, scripts, how they can progress when talking to an insurance company. They even have large buttons such as “Denied: Not Medically Necessary” to help guide visitors to find the right support for them.

A story of encouragement 

The article has turned out to be an exceptionally valuable resource. But Joe points to a more intangible idea as the main benefit of his website. 

Encouragement. 

Many people, when they get a letter rejecting their coverage, feel a strong sense of despair. These are families who are already struggling substantially. The act of realizing there is an issue and taking steps to get support can be draining or traumatic even in itself.

For families that don’t have savings to fall back on, this letter can lead to feelings of hopelessness. Where will you get the money to get this treatment you so need? 

That’s why Joe says, when visitors come to their website, they “should expect to find encouragement.” He says it’s, “something we focus on more than folks even realize,” clarifying that it’s “so important because your expectations are basic and reasonable.”

“Encouragement is number one.”

The situation is getting better

As we mentioned at the beginning, there were adjustments made to the federal parity law to make it more difficult for insurance companies to deny coverage. 

Joe says that “The history of health insurance coverage for mental health is a complicated one.” He explains that for many years, insurance companies were legally permitted to restrict coverage of mental health in a way that was quite broad. 

But due to the hard work and persistence of people like Joe, “There were a number of laws passed over the last years that obliged companies to cover mental health.” 

It is important that this work isn’t in vain or taken for granted, especially now as funding risks being withdrawn for healthcare – which includes mental health. Again, we need to come back to Joe’s idea encouragement. 

As he says, “your expectations are basic and reasonable.”

Don’t let them be denied.

Do you need help with mental health insurance?

If you have been denied coverage for mental health treatment, you can reach out to Joe and his team at Cover My Mental Health. The website features extensive resources and avenues to receive support in English and Spanish.

For anything else, you can always contact us directly at MHAI and we will get back to you as soon as possible.