Seasonal Depression and Your Health Insurance

What is Seasonal Affective Disorder?

Seasonal Affective Disorder (SAD) is a type of depression that occurs at the same time each year. Symptoms typically begin in the fall and last through the winter months, often worsening until spring. Though less common, people with the opposite pattern will see their symptoms begin in the spring or summer.

According to the National Center for Biotechnology Information (NCBI), symptoms include hopelessness, increased appetite and weight gain, increased sleep, energy loss, inability to concentrate, loss of interest in work or other activities, sluggishness, withdrawal and irritability. It is estimated that between 10 and 20% of depression cases occur in a seasonal pattern. Mental Health America (MHA) reports that three-fourths of those with SAD are women. Without treatment this form of depression can be expected to recur at the same time every year or develop into major depression.


Limited Coverage Options

In 2003 the National Alliance on Mental Illness (NAMI) conducted an online survey that found 56% of those with mental illnesses were covered by private insurance. However, one-fourth of respondents said that private health insurance had been denied because of a mental illness, and 25% also claimed that they had been discouraged from jobs or moved to programs like Medicaid because of the lack of private insurance coverage. Just 17% of those with private insurance found adequate coverage for mental health treatment.

The Affordable Care Act has since ended insurance companies’ practice of setting maximum lifetime benefits on essential services such as mental health, and these services should be included in benefit plans. As of January 1, 2014, no one can be denied coverage due to a pre-existing condition, including mental illness.

Several treatment options exist for SAD. While medication or counseling is sometimes effective, the most common treatment is light therapy. Light therapy, or the practice of exposing sufferers of SAD to light lamps for several hours a day, is conducted at home through the use of units designed specifically for SAD. It is usually covered by private insurance as long as the patient meets the DSM-IV criteria for recurrent depression and provides proper paperwork from a doctor. Some insurance companies will also require that the light therapy unit is purchased through an approved vendor.

CIGNA, a major health insurance provider, notes that they will not cover any other light treatment outside of light boxes, as it is considered experimental. If a light box is not covered by insurance, it will typically cost around $200.


Additional Resources

Mental illness is a difficult struggle for those who suffer from it, especially when faced with questions regarding insurance coverage. Fortunately there are a number of resources that can provide support and information for those with SAD.

Substance Abuse and Mental Health Services Administration (SAMHSA) — This government website provides publications, links to treatment facilities, blogs and information on the Affordable Care Act’s effect on mental health treatment.

National Alliance on Mental Illness (NAMI) — A comprehensive website that provides links to treatment, services and programs, publications, research and other educational resources for those with mental illnesses.

Mental Health America (MHA) — MHA’s website includes a section on affordable treatment, as well as information on getting help paying for prescriptions.

American Psychological Association (APA) — The APA website features a variety of psychology topics. There are a number of articles about mental health and insurance as well.