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Question by Kate R: What constitutes a “serious mental health diagnosis” for medical insurance coverage?
My insurance/plan (Blue Shield of CA) will only cover psychotherapy for “serious mental health diagnoses”. I asked them on the phone if they could give me a list of what DSM-IV codes are considered serious, and they said I have to ask about a specific code and they’ll tell me yes or no. I wanted to know in advance so that if my mental health provider was debating between a few diagnoses, we could take into consideration which one would be covered. Does anyone have a list of codes that are generally considered serious mental health diagnoses by medical insurance companies?

Best answer:

Answer by canada_winnipeg_man
A “serious mental health diagnosis” The bill states: “Severe mental illness is defined through diagnosis, disability and duration, and includes disorders with psychotic symptoms such as schizophrenia, schizoaffective disorder, manic depressive disorder, autism, as well as severe forms of other disorders such as major depression, panic disorder, and obsessive compulsive disorder.”They may have suspected that something was not quite right with your mental health for years or your diagnosis may have come as a shock. Either way, in order to get the most out of any treatment insurance coverage plan you must first come to terms with how your mental illness will be apart of your life. No matter what official diagnosis you have been given, any mental illness is a life long struggle that can either consume your life or just become another facet of who you already are.
A trained medical professional will be able to give you further guidance. Good Luck & Take care as always!!!

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