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- Health insurance gives your team fast access to private GP appointments, diagnostic tests, and medical treatment.
- While it's possible to get health insurance for mental health, there are big exclusions to consider: health insurance will rarely cover chronic or pre-existing mental health conditions.
- These exclusions prevent a lot of employees who really need support from getting it, which leaves them to struggle or pay for expensive private therapy themselves.
- Accessing mental health support via health insurance can be daunting, take a long time, and result in extra costs, such as if your employee needs to pay an excess fee on their claim.
- A therapy-focused mental health solution like Spill gives your employees free access to private counselling and covers chronic and pre-existing mental health conditions.
As a specialist therapy provider for employees, we get a lot of questions from companies weighing up Spill against employee health insurance for mental health. Many companies, quite understandably, worry they’ll be paying twice for mental health support. And many more have questions about how health insurance covers mental health, and how Spill is different.
If you’re facing a similar dilemma, you’re in the right place. Here, you’ll find out what health insurance with mental health coverage really means and why a therapy solution like Spill is often a better option for companies committed to effectively supporting their team’s mental wellbeing.
But first, let’s start with a quick recap of what health insurance actually covers.
What does health insurance cover?
There’s a vastly more detailed version of what health insurance covers in our employee health insurance buyer’s guide, but in short: employee (or company or group or business) health insurance gives your team access to private medical care for acute — short-term and new — health conditions.
With their health insurance, your employees can benefit from 24/7 access to medical advice, GP appointments, diagnostic tests (blood tests, X-rays), and treatment as either an outpatient, inpatient, or day patient. Every appointment and treatment will take place in a private facility and because they can skip the NHS’ growing waitlist, employees can be diagnosed and treated in a matter of weeks.
Most providers offer a basic level of coverage with optional extras for companies to add on to tailor their policy for their team’s needs. Mental health support, dental and eye care, travel cover, and more extensive outpatient tests, scans, and treatments are all offered as extras from some of the big business health insurance providers.
Download our free health insurance evaluation checklist
What does health insurance not cover?
Ah, the small print. Taking out any kind of insurance requires careful reading of the finer details and health insurance is no different: if you’ve ever had a breakdown and found your car but not yourself/belongings/dog being towed because of the small print in your insurance cover (true story), you’ll know exactly how it feels.
As well as types of medical treatment that simply aren’t covered at all (A&E treatment, cosmetics, pregnancy, addiction, intensive care, and weight loss treatments to name a few), there are two key exclusions that you absolutely need to know:
1. Health insurance doesn’t cover chronic conditions
A chronic condition is one that requires ongoing management and will never be cured. Diabetes, asthma, arthritis, and Alzheimer’s disease are all examples of chronic conditions. This clause is one of the reasons why the cost of health insurance increases with employee age: 58% of people over the age of 60 have a chronic condition compared to just 14% under the age of 40. As a result, the older someone is, the more likely it is they’ll need to make a claim.
2. Health insurance doesn’t cover pre-existing conditions
A pre-existing condition is a symptom or illness that an employee has been to see a doctor about three to five years before joining the health insurance plan. Many chronic conditions are also pre-existing conditions, and this exclusion also means pre-existing mental health conditions are not eligible for cover.
Given that almost half of the UK population has a long-term health problem (45.7% of men and 50.1% of women), that’s a lot of people unable to receive private medical care for something that likely affects their daily life. A 2019 report found that the most common types of chronic conditions were musculoskeletal (17%), heart and circulatory (11%), mental, behavioural, and neurodevelopmental (9%), diabetes and similar conditions (8%), and respiratory (8%). But when looking specifically at adults under the age of 45, mental, behavioural, and neurodevelopmental conditions took the top spot as the most common condition.
Health insurance for pre-existing conditions: why aren’t they covered?
Considering a large chunk of the working population is experiencing a chronic — and by health insurance standards, pre-existing — mental health condition, it begs the question of why isn’t mental health covered by insurance?
Well, mental health and physical health are two halves of the same whole: when one declines, the other isn’t far behind. While health insurance can be a great way to get fast access to treatment, insurers want to avoid having to pay out as much as possible. That’s why chronic and pre-existing conditions are excluded — people with those conditions will likely need to make regular claims for their ongoing treatment. Mental health recovery can take a long time and if physical health is also affected, well, that’s a high-risk individual when it comes to getting insurance companies to part with their cash.
Of course, mental health conditions aren’t necessarily always ‘cured’. And that’s why health insurance for pre-existing conditions is hard to come by. One 2017 study found that half of people recovering from a depressive episode will experience a relapse within a year, while the majority (79%) do so within the first six months after treatment. It’s also been suggested that the severity of depression and resistance to treatment increase with each successive episode and an editorial in the British Journal of General Practice highlights the benefits of ongoing care for depression to prevent relapse as a result.
Proper mental health recovery and support is a long-game and that makes insurance companies nervous. Caring for someone with depression isn’t the same as healing a broken leg — it involves time, relapses, and ongoing support. And in the insurance world, that means multiple claims and multiple payouts.
And yet, with poor mental health classified as being the second-largest source of burden of disease in England, the big insurance companies are starting to wake up to the fact that people want mental health support. As a result, many have started including mental health cover in their policies.
But don’t get too excited.
More often than not, this is a very diluted version of what we deem to be effective support. It can take a long time to actually get access to treatment (i.e. therapy) and more often than not, therapy won’t be offered as a solution. Many providers bolt their mental health support on as an ‘employee assistance programme’, or EAP. This type of EAP is known as an embedded EAP and is generally considered the least effective type of EAP on the market due to hidden costs, a lack of specialist support, and lower quality therapy.
It’s worth being aware as well that while some providers have now waived their exclusion of pre-existing mental health conditions, they do still have exclusions in place — namely behavioural, learning, and developmental conditions, as well as individuals dealing with addiction. This includes conditions such as OCD, ADHD, bipolar disorder, autism, and many others. These conditions are some of the most disruptive to everyday life and therapy can be a lifeline for people living with them.
Spill surveys the wellbeing of your team every week with a team meeting integration and then proactively gets mental health support to those in need.
How health insurance for mental health works
The exact process of how to get mental health support will depend on your health insurance provider, but here’s a general view of how health insurance that covers mental health works for your employees.
Step 1: Your employee decides they need support
Once they realise they need support, your struggling employee will have to call the health insurance provider and speak to a stranger on the phone.
Step 2: Your employee explains their symptoms
During the call, your employee will need to explain how they’re feeling. The health insurance provider will then assess what kind of support your employee needs. In some cases, your employee will be asked to call another person who can more accurately assess their concerns.
Step 3: Your employee gets treatment
What this treatment looks like will depend on the decision of the health insurance provider and your level of coverage. They could be directed towards self-help resources like articles, videos, or podcasts, or they could have therapy. This could be in person or virtual but it will need to be arranged and could take anything from a few hours to days, to even weeks, leaving your employee waiting for support.
Step 4: Your employee finishes treatment
As part of their care, your employee might get one or a few sessions of therapy before they’re signed off as being ‘treated’. If your health insurance plan includes an excess, they may need to pay part of the bill.
For a four-step process, we can see an awful lot of red flags for your employee’s wellbeing:
🚩 Your employee has to realise they need support: by this point, they could be in a desperate situation or be too mentally unwell to make that decision.
🚩 Your employee needs to know the number to call: the stigma around mental health and the fear of people knowing can be enough to deter them from asking for the contact details.
🚩 Your employee has to speak to a stranger: picking up the phone can be daunting at any time, but picking up the phone to explain symptoms to a stranger can be intimidating enough to stop them from getting help.
🚩 Your employee has to make the call without knowing what treatment they’ll get: and that’s not only ambiguous and frustrating, but could leave them feeling helpless and uncared for.
🚩 Your employee will have to wait for treatment: for someone who needs instant support, waiting can cause them to spiral further downwards.
🚩 Your employee won’t able to choose their therapist: having a choice based on gender or therapeutic speciality can put your employee at ease and ensure they get the right support for their challenges.
🚩 Your employee will have admin to worry about: they’ll need to make a claim and perhaps have to pay the excess all the while trying to recover, which is a significant mental burden on their existing challenge.
Hmm. Honestly, we don’t feel great about this. At Spill, we believe that mental health support should come without red flags, barriers, and extra mental burden.
So, with that in mind, here’s the case for getting mental health support with Spill.
How is Spill different from health insurance that covers mental health?
Spill is a platform that makes effective therapy accessible, affordable, and free at the point of access. Companies pay a monthly fee (that’s on a rolling 30-day contract, so you really can cancel anytime) and that’s it: your team can start getting private therapy straight away.
Here’s how an employee in a company with Spill can get support.
Step 1a: Your employee decides they want some extra support
This could be to help with a known, pre-existing problem, or they could be struggling with something in their work or personal life: relationships, trouble sleeping, imposter syndrome, or just generally feeling blue. Therapy with Spill is for anything and everything that’s affecting your team’s headspace.
Step 1b: Your employee is proactively guided towards therapy
Even if one of your employees hasn’t yet realised that they could benefit from support, Spill is already looking out for them: with weekly team mood surveys, our unique algorithm finds the people in your company who are struggling. Then, one of the Spill therapists will proactively reach out to offer them personal support and the offer of a therapy session. Known as Spill Safety Net, it's our way of making sure no employee goes without help.
Step 2: Your employee books a session with Spill
As a Slack or MS Teams integration, Spill sits in your existing tech stack, but it can also be accessed by a web app, too. Your employee simply has to click the Spill icon in Slack, where they can book a one-off session of therapy or start a longer course of therapy. Straight away, they’ll be taken to the booking page, where they can choose the preferred time for their session (including evening and weekends) as well as their therapist: next-day sessions are often available.
Step 3: Your employee has their session
After their session, your employee will either continue with their course of therapy or if they’ve booked a one-off session, can choose to book another one or start a longer course. Employees can choose to speak to the same therapist again or work with someone new.
It’s a bit of a different process isn’t it? Here’s how we make accessing therapy different from health insurance that covers mental health.
✅ Your employee gets proactive mental health care: if we think they’re struggling, a Spill counsellor will offer personal support and encourage them to book a therapy session.
✅ Your employee’s privacy is respected: it takes just a few clicks to book a session and your employee won’t have to ask anyone how to do it or justify their reasons for wanting to book a session.
✅ Your employee is guaranteed to get therapy: no one with a pre-existing or chronic mental health condition is excluded from Spill and everyone can book therapy whenever they want it.
✅ Your employee can get therapy within 24 hours: next-day sessions are often available to book and sometimes, it’s possible to book a same-day session, meaning your employee won’t be left waiting for help when they really need it.
✅ Your employee can choose their therapist: at the booking stage, your employee can choose their therapist based on gender, speciality, and language, and can choose to speak to the same person again in future sessions.
✅ Your employee doesn’t have to pay a thing: Spill is free at the point of access, meaning your team don’t have to pay at any point for getting access to private therapy.
✅ Your employee doesn’t have any admin to worry about: once their session is over, there’s nothing more for your employee to do except look after themselves.
Here at Spill, we’re really proud of our proactive approach to mental health and this combination of proactive mental health screening and personal therapy has been shown to generate the biggest return on investment than any other employee mental health support. For every £1, you can expect £6.30 in return.
But that’s not all. Here’s what else you can expect from partnering with Spill:
✍️ The option to privately message a therapist rather than have a full session
🌎 Therapy in 15 languages covering 80+ specialisms
👀 Detailed usage reports for total transparency on Spill’s effectiveness
💰 Set a budget and only pay for therapy sessions actually used
🧠 Access to the top 13% of qualified, BACP- or NCS- registered therapists
⚡ First-class customer support
🤝 Workshops and training for individuals or teams with our preferred partners
Protect your team’s brainpower
Choosing to offer mental health support for your team is an incredible thing to do and one that will benefit them and your business continuously. Your company is a success because of your team’s brainpower and we believe that brainpower needs protecting.
So yes, health insurance for mental health does exist (albeit with a heap of restrictions) but that doesn’t mean it's necessarily the best option. If your team is struggling with their mental wellbeing and you’re truly committed to supporting them, a therapy-focused tool like Spill would be a far more effective solution: for your business and for your team.
A lot of health insurance providers say they offer mental health cover but this doesn’t include pre-existing mental conditions. And for the providers who do say they cover pre-existing conditions, be sure to check the small print: behavioural, learning, and developmental conditions, such as OCD, ADHD, bipolar disorder, autism, and addiction, are often still excluded.
Proper mental health recovery and support takes a long time, and relapses can occur. Insurance companies don’t like parting with their cash, which is why someone with a pre-existing mental health condition is deemed high-risk: caring for someone with a mental health challenge involves time, relapses, and ongoing support. And in the insurance world, that means multiple claims and multiple payouts.
Download our free health insurance evaluation checklist
Check how much it would cost to support your team's mental wellbeing by providing next-day access to mental health support.