In recent years there has been an increased awareness of mental health issues and the importance of seeking treatment for or openly discussing issues of depression, anxiety, stress, ADHD or eating disorders without fear of being stigmatised. While it is still difficult to talk about mental illness in today’s culture, a number of factors such as mental health awareness campaigns on social media, increased news coverage of mental health issues and several high-profile celebrities stories of their own struggles have started to make it easier. This is undoubtedly a good thing.

Whether you are personally considering speaking with a therapist or you are an employer that wants to ensure your staff have access to an adequate level of mental health insurance cover, you may be wondering how such treatment is covered under your group insurance plan. Given that the terminology for the treatment for mental illnesses is sometimes labeled differently by different insurers, we would recommend searching within your plan’s table of benefits for psychiatric care, psychotherapy, mental health and rehabilitation treatment.

What to look for in your plan’s benefits

Usually, mental health treatment will have a limit on the number of covered visits per policy year (often 20 sessions) and sometimes a specific limit on the amount covered for each visit as well. It’s important to check if your plan has any such limits prior to seeking therapy or starting a treatment plan so as to ensure that you are not left paying the bill. Please note that treatments such as speech therapy, behavioral therapy and occupational therapy are often covered under the psychiatric care benefit or sometimes not covered at all – if you are considering any such treatment for yourself or a family member, get in contact with your insurer to check exactly how the treatment is or is not covered. Marriage counselling is usually only covered if both partners are covered under the plan. Many insurers also require members to get pre-authorization prior to starting any type of mental health treatment so please keep this in mind.

A word of warning about unlicensed therapists – since they do exist. Insurers will only be able to cover treatment received by a licensed therapist, psychiatrist or counsellor. In China, insurers can only cover treatment received at a licensed medical facility that can issue an official tax receipt (known as a fapiao). We would, therefore, suggest checking with both the treating facility and your insurer to ensure there will be no issues with your insurance cover.

Under many group insurance plans, the standard mental health benefit has a 50% co-pay, meaning the insurer will cover 50% of the cost of the treatment and the patient pays the other 50%. While this might have previously been viewed as adequate we are seeing a trend amongst our clients to decrease this co-pay to 20% (meaning the insurer covers 80% of the treatment) or removing the co-pay altogether so the treatment is covered in full.

Insurance and remote/online counselling

If you or your employees are based in a country with limited access to English-speaking therapists, psychiatrists or counsellors, then you will need to check if your insurance plan covers remote or telephone-based counselling. Many insurers will cover remote counselling on an ad hoc basis, meaning that if you can prove that there are no resources locally in the city or area where you live and there is a medical necessity for treatment, then they will agree to the remote (or sometimes online) counselling sessions to be covered. An increasing number of insurers are also making access to remote counselling standard under their insurance plans. If your insurer has not yet made this change, we would suggest asking your broker to request this change be made from your next renewal. Online counselling is also becoming increasingly available. 

Essential resources

In terms of finding a good therapist, the first place to check is your insurer’s direct billing network list, which will normally allow you to filter facilities in your area by specialities such as psychiatry and psychology. Many private clinics and hospitals with a focused on expats will also list their doctors on their website and you can also filter by speciality. In China, There are mental health professionals in Shanghai at Raffles Medical, ParkwayHealth, United Family Hospital, Global HealthCare and Jiahui Health, and in Beijing at Raffles Medical, United Family Hospital and Vista Clinic.

Rebhaibilition recommended for alcohol and drug abuse is also usually covered by medical insurance plans – assuming there is a medical necessity and a doctor’s recommendation. Again, check with your insurer prior to starting any type of treatment. Thailand is a popular destination for rehabilitation centers in the region, including Inspire Rehab Thailand, DARA Rehab, The Cabin (also in Hong Kong), and there is also The Solace Sabah Retreat in Borneo, Malaysia.

We would like also to share some useful resources for people struggling with mental health issues that you may share with your friends, colleagues or employees.

Lifeline: 400 toll-free helpline number available to anyone and everyone in China, the helpline offers an emotional support service, helping you to gain another perspective and connecting you with other support services as needed. Trained volunteers offer emotional support and assist you to clarify options and choices that are right for you.

Contact USA is a crisis helpline membership organization in the US devoted to establishing best practice standards of service for crisis helplines.

Addiction Friend is a Hong-Kong based team of addiction professionals and advisers with knowledge of local and international addiction treatment services, including in China.

Time to Change, a mental health campaign in the United Kingdom, launched in 2007 with the objective of reducing mental health-related stigma and discrimination. If you’re experiencing mental health problems or need urgent support, there are lots of places you can go to for help: listed here.

SIMHA, a multidisciplinary professional association of therapists who provide mental health services to the international communities in Shanghai. Founded in 2008, SIMHA’s goals are to improve the quality, quantity, and accessibility of mental health services available to the international communities in Shanghai.

If you are insured by Cigna International (or Cigna China), you should have access to Cigna’s International Employee Assistance Program which gives members 24/7 access to a professional counselor – up to 5 face-to-face sessions. Any time, any day, Cigna members can contact the service for live assistance including: short-term professional counseling, in-the-moment support by phone, email or web. Support is available in your language, and there is no cost to Cigna members for this service.

Take action

Finally, and perhaps most importantly, if you are concerned that a colleague or loved one might be struggling, here is some critical advice on what to look for and how you might be able to help.

To quote a One World Cover client who recently wrote in a communication to their staff: “You would go to the doctor if you had a broken leg, right?” So please take action and take advantage of the mental health resources available to you, particularly if treatment is covered under your insurance plan.