Dr. Mojgan Makki, Board Certified Child and Adolescent Psychiatrist with Psychiatry Studio in Chicago, was treating an adolescent patient with ADHD. The patient experienced serious side effects from the oral medication, requiring Dr. Makki to pursue the next clinically appropriate plan: a transdermal patch for ADHD treatment.
“Time was of the essence,” says Dr. Makki. “We needed an effective treatment plan to minimize disabilities and disruption caused by the disorder in the child’s life, whether at home or school.”
Based on years of experience, Dr. Makki anticipated that the patient’s insurance wouldn’t cover the alternate delivery method, which could interfere with the patient’s recovery.
Insurance Lacks Mental Health Support
About one in five people in the United States live with a mental health condition, yet only a fraction of those individuals are receiving the proper mental health care. Even though the stigma around mental health is changing and more people are trying to seek treatment, many people are facing barriers from their insurance in getting the mental health support they need.
According to a KFF 2025 report, one in five insurance claims denies mental health care coverage. An estimated 15 to 22 million mental health claims are denied annually by private insurers.
These denials from insurance can put a stop to a person’s pursuit of treating their mental health. The Wall Street Journal reports that less than 1 percent of individuals appeal their denied claims. Consequently, an estimated 50 percent of mental health patients and 75 percent of substance use disorder patients do not have access to care.
Helping Patients Obtain Mental Health Support
Hearing a “no” from an insurance company doesn’t have to mark the end of someone’s mental health care. Cover My Mental Health is a nonprofit founded on the recognition that access to mental health treatment often depends not only on diagnosis and clinical judgement, but on navigating the insurance system itself. To help patients, doctors, and clinicians overcome insurance barriers, Cover My Mental Health provides practical tools to respond to coverage denials and pursue appeals.
Cover My Mental Health offers resources including:
Medical necessity letter templates that clinicians can adapt to specific casesGuidance on communicating with insurance representatives, including what information to provide and what to avoidStep-by-step instructions for filing a formal complaint with insurers and regulatorsExplanations of federal and state mental health parity protections
Using Cover My Mental Health’s resources, Dr. Makki wrote a medical necessity letter for her young patient. The letter emphasized that the transdermal patch was medically necessary to support consistent treatment, symptom management, and improved daily functioning. After submitting it, she received approval for insurance coverage in less than one day.
“Cover My Mental Health translates legal protections into practical solutions — so patients don’t just have rights, they have results,” says Lisa Gomez, the former Assistant Secretary of Labor for Employee Benefit Security and Cover My Mental Health board member.
How to Help
Cover My Mental Health NFP provides education and guidance to patients whose insurance is denying them health care coverage. Donations help Cover My Mental Health to continue advocating for mental health care access.
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Joe Feldman is the President and Founder of Cover My Mental Health. Feldman’s advocacy for mental healthcare access has included founding nonprofit Cover My Mental Health, a previous board role with Kennedy Forum Illinois, and appointment as a consumer representative to the National Association of Insurance Commissioners. Feldman was the lead author of an article in the Journal of Psychiatric Practice on medical necessity letters and has made presentations to dozens of clinicians, advocacy groups, parents, and community groups towards improving access to mental health and substance use disorder care.