Across Virginia, people are hitting the same wall with mental health insurance. Most insurance complaints point to delayed care, denied claims, and a system that feels confusing and hard to move through when support is already overdue.
These insurance barriers to mental health care in Virginia can interrupt treatment, worsen symptoms, and leave people feeling stuck when they’re already vulnerable. Mission Connection can support you in managing these barriers, making sure you can access the treatments you need.
This article can also help you understand mental health insurance denials in Virginia, as it explores why people are struggling with their mental health benefits and what recent insurance complaints are about. It also looks at the real-life impact these barriers have and what you can do.
Why Many People Are Struggling to Use Their Mental Health Benefits
Unfortunately, many people across Virginia are finding that having insurance doesn’t necessarily mean having access to mental health care. Even when their plans advertise behavioral health coverage, they run into mental health insurance denials in Virginia and unclear explanations about why. In the following sections, we take a look at why this might be.
What the Numbers Say About Mental Health Claim Denials
Reporting on states’ insurance claims shows that mental health claim denials aren’t rare. In Virginia, insurance companies deny nearly 17% of all mental health claims, with therapy offices accounting for around 8.1% of denials.1 Meaning that most people get rejected for treatment before they even start.
Virginia’s Mental Health Parity Law ensures equal treatment between mental and physical health coverage.2 But lack of understanding in how this law is enforced can leave people facing denied mental health claims for reasons that feel vague or inconsistent. For instance, they may be questioned about “medical necessity” or missing authorizations.
Where you live plays a role in this as well. In places like Fairfax and Henrico Counties and throughout Hampton Roads, the demand for mental health care exceeds the number of providers that are available. This has become a pattern with mental health provider shortages in Virginia, where access remains limited even when people have insurance coverage.
Trends That Are Showing up From Insurance Complaints
A growing number of Virginia insurance complaints related to mental health suggest that many people have come across the same barrier to accessing care. The Bureau of Insurance showed that insurance companies upheld 64% of closed internal appeals and 40% of closed external appeals of denied mental health claims in Virginia. And that the largest complaints for mental health had to do with utilization management, which accounted for 38% of the complaints.3
Essentially, most people reported being told services aren’t “medically necessary,” even when recommended by a licensed provider. Others describe long delays tied to prior authorization requirements that stalled care before it even began. This means that many people aren’t getting the proper mental health care at the right time.
Mission Connection offers flexible outpatient care for adults needing more than weekly therapy. Our in-person and telehealth programs include individual, group, and experiential therapy, along with psychiatric care and medication management.
We treat anxiety, depression, trauma, and bipolar disorder using evidence-based approaches like CBT, DBT, mindfulness, and trauma-focused therapies. Designed to fit into daily life, our services provide consistent support without requiring residential care.
How Insurance Barriers Impact Real-Life Mental Health Care
Insurance barriers don’t just delay care; they change the experience of seeking it. For many Virginians, these disruptions happen at vulnerable moments, making an already heavy situation harder to carry.
Your treatment can become postponed for weeks or months when coverage gets delayed, or a claim gets denied. For example, someone waiting for approval for therapy in Richmond, VA, might find themselves stuck in limbo while symptoms continue to worsen. We know that these delays are a common theme in Virginia’s insurance complaints involving mental health, especially when insurance requires prior authorization before care can begin.
Another impact these insurance barriers have is that they can disrupt care even once treatment has already started. Sometimes people have changes in coverage, sudden claims denials, or limits on sessions that force them to suddenly stop seeing a provider mid-treatment. In other cases, insurance companies may tell someone they must switch providers to remain covered, even after establishing a relationship.
These disruptions are not only frustrating but can discourage people from getting treatment altogether.
Why Mental Health Insurance Denials in Virginia Keep Happening
Mental health coverage enforcement in Virginia is rarely something you have control over. One contributing factor to these denials happening is how “medical necessity” is defined and applied. Insurers apply medical necessity standards to decide whether a person’s symptoms qualify for a specific type of treatment. But mental health conditions rarely follow a straight line. Therefore, progress can be harder to measure.
For instance, your provider might show that you’re attending all your sessions and doing well, and as a result, your insurance denies continued care. But the reality is that other factors, like past treatment history and behavioral patterns, need to be taken into account. So even when you’re making progress, mental health fluctuates, but you may get denied because your insurance company sees progress and believes you no longer need treatment. This can feel arbitrary and inconsistent.
Another issue is the enforcement of parity laws. Parity laws ensure equal coverage for mental and physical health.4 But concerns about Virginia’s behavioral health parity violations continue to surface through consumer complaints and regulatory reviews. Meaning that insurance companies are not always adhering to the standards of treating mental health on the same level as physical health.
What Can Help When Insurance Gets in the Way
It can feel frustrating and tempting to give up when insurance creates obstacles. While no strategy can get rid of every barrier, there are some steps you can take to make this more manageable.
What You Can Do to Support Access
One of the first steps you can take is to ask clear questions early on. If possible, before treatment begins. Talk to your insurance company and ask whether prior authorization is required, how many sessions are covered, and what documentation is needed. Getting this information early can help with unpleasant surprises later.
Keep simple records of the calls, emails, and claim numbers in case mental health insurance appeals in Virginia become necessary. And if a claim is denied, carefully reviewing the explanation and requesting clarification can help you identify whether the issue is administrative or related to coverage criteria.
Explore Flexible Care Options
Looking into flexible options like telehealth can reduce the barriers of location. Plus, finding out about payment options can help with costs if your insurance denies coverage. Some programs and therapists have sliding scale fees or payment plans to make costs more manageable. This way, you can still receive treatment without the barriers of insurance.
These steps won’t solve every insurance problem. But taking proactive steps can make getting behavioral health insurance access in Virginia more manageable, especially if you’re worried about being denied care.
How Mission Connection Helps Reduce Access Barriers
Mission Connection understands how discouraging it can feel to need support and encounter obstacles every step of the way. As an outpatient provider, our goal is to make treatment feel seamless. That’s why our program offers flexible options that support access to mental health treatment in Virginia, including both in-person and telehealth services.
Mission Connection works with a variety of insurance companies across the country. So we can help you verify your insurance and get the covered care you deserve. And while we can’t control every aspect of coverage, our aim is to make the process collaborative and transparent, so you’ll feel prepared if you’re denied mental health claims in Virginia.
If insurance barriers have made it harder to get the support you need, you don’t have to navigate the problem alone. Reach out to Mission Connection today to learn more about our outpatient mental health services and explore care options designed with accessibility, flexibility, and compassion in mind.
FAQs About Insurance Barriers to Mental Health Care in Virginia
If you’ve encountered barriers to accessing your insurance benefits, you may understandably have some ongoing concerns after the information in this article. To help, we’ve provided the following answers to common questions we receive.
Does Insurance Cover Mental Health?
Yes, most health insurance plans have options that include mental health benefits. You can find out if your insurance offers behavioral health coverage by accessing your member portal or calling the number on the back of your insurance card. It’s important to verify your coverage before starting treatment, as plans vary and approval is not always guaranteed. Issues related to insurance coverage for therapy in Virginia often arise when services are deemed “not medically necessary”, fall outside network rules, or require additional authorization.
What Is the New Mental Health Law in Virginia?
There are several bills that have advanced to address mental health. But most notable is Bill 37.2-601, which has passed to expand funds and access to provide comprehensive mental health services across Virginia.5 The purpose is to provide people with effective, timely, and cost-efficient mental health services.
What Are the Barriers to Accessing Mental Health Services?
Barriers to accessing mental health services usually include cost, stigma, provider shortages, long waitlists, geographical limitations, and lack of insurance parity.6 On top of these, confusion over medical necessity and prior approvals further restricts behavioral health insurance access in Virginia, even for people who are insured and actively seeking care.
How Do I Complain About an Insurance Company in Virginia?
You can file a complaint about an insurance company through Virginia’s Bureau of Insurance or by calling them toll-free at 1-877-310-6560. The Bureau reviews consumer concerns related to coverage decisions, network adequacy, and claims handling. Many Virginia insurance complaints involving mental health can help the state understand the issues around claims denials.
How Does Mission Connection Help With Insurance Barriers in Virginia?
We help you access mental health treatment in Virginia by offering flexible outpatient care that includes both in-person and telehealth options. Our team will work with you by verifying insurance and helping you understand your options. While we can’t eliminate every barrier, we’ll work with you and your insurance company to cover your treatment as best we can. And if insurance denies treatment, we offer flexible payment options so that care is still accessible.
References
- White, S. & State Corporation Commission Bureau of Insurance. (2025). Summary of 2024 insurance carrier data. In State Corporation Commission Bureau of Insurance. https://www.scc.virginia.gov/media/sccvirginiagov-home/consumer-home/insurance/life-amp-health/tips-guides-amp-publications/2025-mental-health-parity-report-final-103125.pdf
- DiGioia, S., & DiGioia, S. (2024, October 25). Mental Health Parity Act-Final Rules – Virginia Association for Behavior Analysis. Virginia Association for Behavior Analysis. https://virginiaaba.org/mental-health-parity-act-final-rules/
- State Corporation Commission. (n.d.). RD721 – Claims – Complaints – Appeals Mental Health, Substance Use Disorder Benefits, Network Adequacy Comparative Analyses Summary of 2024 Insurance Carrier Data – November 1, 2025. https://rga.lis.virginia.gov/Published/2025/RD721
- National Alliance on Mental Illness. (2026, January 6). What is Mental Health Parity? NAMI. https://www.nami.org/living-with-a-mental-health-condition/understanding-health-insurance/what-is-mental-health-parity/
- LIS Virginia Law (n.d.). Code of Virginia § 37.2-601. Behavioral Health Authorities; Purpose. https://law.lis.virginia.gov/vacode/title37.2/chapter6/section37.2-601/
- Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – Population Health, 15, 100847. https://doi.org/10.1016/j.ssmph.2021.100847
