To Cover or Not to Cover: Mental Health Apps and Health Insurance - On Second Thought: from Iffy to Witty Thoughts
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To Cover or Not to Cover: Mental Health Apps and Health Insurance

To Cover or Not to Cover: Mental Health Apps and Health Insurance

One benefit that rose from the COVID-19 pandemic is greater innovation, creativity, and a push for virtually-based options in healthcare and behavioral health. Telepsychiatry and telehealth counseling were almost nonexistent before 2020; however, there has been an explosion of services offered via virtual platforms since the pandemic. Not only have virtual counseling services seen a boom, but mental health apps have also gained popularity. With so many app-based resources available to people seeking help, assistance in coverage of costs from healthcare insurance may promote greater access to these services.

According to Forbes, Noom, a popular weight loss app, has 50 million user downloads and generated $237 million in revenue. Statistics such as these offer strong evidence that users like the accessibility and flexibility of such resources at their fingertips throughout the day. Data such as this offers opportunities for mental health support to be offered virtually to individuals who may not seek traditional counseling services, thus promoting wellness for more people. While mental health apps are not designed to diagnose a psychiatric condition or substitute professional services from a therapist, they can offer support and resources.

With an explosion of mental health apps coming on the market, there is considerable opportunity for research into the efficacy of such treatment modalities. Mental health professionals would benefit from pushing for the validation of virtual services through thorough evaluation and endorsement. Doing so will promote the reliability of this support service covered by healthcare insurance. A 2020 meta-analysis published in the Journal of Medical Internet Research found that using apps for anxiety and depression holds clear clinical advantages when used independently for self-management or as adjunctive treatments to professional services.

Health insurance companies increasingly cover virtual options that offer access to a therapist who delivers counseling via a telehealth platform. Virtual options that offer access to a live therapist who offers traditional counseling sessions via this platform may have increased traction with insurance companies for coverage. Apps that offer self-directed treatment through mobile health tools are not being reimbursed by payers consistently. According to a recent study published in 2019, insurance companies do not have the billing structure to pay for an app that does not involve clinician activity. The lack of a proper billing code produced by the services in the app makes the services offered less likely to receive substantial reimbursement.

Despite insurance carriers not consistently offering reimbursement for access to self-directed mental health app resources, many employers are. The Conference Board cited in 2022 that organizations offering programs to support emotional well-being increased by 22% since the pandemic. However, only 53% of employers offer virtual therapeutic platforms to support mental health, promote wellness, and reduce stress. The survey identified a greater need for mental health support, and coverage for access to such virtual platforms is a missed opportunity.

A lasting impact of the COVID-19 pandemic will likely be an increased focus on mental health and well-being. Virtual, app-based mental health resources offer new avenues of support for individuals struggling with stress, depression, and anxiety. Employers and schools can support the outcomes of their employees and students by embracing innovative virtual resources to help them.