GIMBHI's Q&A with Joe Feldman, Founder of Cover My Mental Health
Joe Feldman is the founder and president of the nonprofit Cover My Mental Health (www.covermymentalhealth.org). His advocacy for mental health care access has included a previous board role with Kennedy Forum Illinois and a current appointment as a consumer representative to the National Association of Insurance Commissioners. Feldman was the lead author of a 2021 article in the Journal of Psychiatric Practice on medical necessity letters and a 2026 article in Capital Psychiatry on peer-to-peer review preparation. He has made presentations across the country to clinicians, advocacy groups, parents, and community groups toward improving access to mental health and substance use disorder care.
1. You spent over two decades as a board member and advisor to private equity-owned and growth-stage companies before turning your focus to mental health care. What led you to that shift, and why this cause?
It was my experience as a dad that led me to get involved in mental health care advocacy. One of our kids needed a higher level of care early in high school. While the psychiatrist and we were clear that residential care was needed, our insurance company denied the care as “not medically necessary.” The insurer was wrong, and after three years, we won a federal lawsuit against our insurer when a judge agreed that they were wrong.
That experience taught me about the many obstacles that insurers put in the way of care and how most families… even clinicians… just give up.
A year after retiring from my professional career at the end of 2022, a conversation with a psychiatrist friend of mine who runs a clinic in suburban Chicago led to the idea of starting Cover My Mental Health. My goal is to provide encouragement to patients, families, and clinicians that they do not have to take “no” for an answer. With encouragement, visitors to our site can access immediately actionable resources to push back on insurers standing in the way of necessary, appropriate care.
2. Cover My Mental Health is built around helping individuals overcome insurance obstacles to mental health and substance use care. What was the specific problem you set out to solve, and why is insurance such a barrier?
The barrier that I focus on most is discouragement.
Whether you’re talking about patients and their families or mental health clinicians, when insurers stand in the way of individuals accessing the care they need, discouragement can overwhelm. Treatment plans can be out of reach or stopped when an insurer’s clinician network is inadequate or when care is denied as “not medically necessary.” Our focus at Cover My Mental Health is to encourage patients and clinicians that they do not have to take “no” for an answer..
3. So much of your work centers on the gap between what care people are entitled to and what they can actually access. Where does that gap come from, and what would it take to close it?
People’s expectations of their insurer are pretty straightforward: access to competent clinicians, coverage of the care those clinicians determine is appropriate, timely payment of claims, and a straightforward process in the case of any disputes. Sadly, when it comes to mental health care, those expectations are too often not met.
With encouragement as a foundation, our resources are immediately actionable to address insurer obstacles. For example, we provide guidance and a worksheet to document a search for an in-network clinician, a template for a clinician to document that their treatment plan is medically necessary, and specific steps to take “if at first you don’t succeed.” Where helpful, we also provide specific scripts that can be used
when talking to an insurer.
4. The Mental Health Parity and Addiction Equity Act and cases like Wit v. United Behavioral Health sit behind a lot of your work. Why does parity remain so hard to enforce in practice, decades after it became law?
Our resources have similarities to the Wit v United Behavioral Health case, not so much with the Parity Act.
The success of the Wit case is based on UBH’s obligations as specified in health insurance policies to provide coverage for “medically necessary” care as well as to follow their internal procedures for making determinations on payment of claims. Similarly, our resources similarly rely on those policy (that is: “contractual”) obligations. For example, our medical necessity letter templates support a clinician’s decision-making based on their training and use of generally accepted standards of care. The letter asserts that the care is appropriate and medically necessary… and as such, should be covered as per the contract.
The Parity Act has definitely changed expectations and mental health care should be covered just like physical health. That’s a very good thing.
As for enforcement, a stubborn challenge for the law is that the obligation is comparative, not mandatory. The obligation of mental health care coverage specifies that it be comparable to physical health care. It’s not that such a comparison is impossible, it’s that there’s enough uncertainty that insurers have been able to avoid compliance. As one insurance executive told me, ““The federal [law] went a long way to make sure [coverage is] at least on par with medical benefits. There is still a lot of wiggle room as medical benefits aren’t bucketed the same as mental health benefits are.”
5. Through your board work with Thresholds, you advocate for ideas like “Housing is Recovery.” How does community-based and systems-level work connect to the individual coverage battles Cover My Mental Health takes on?
Thresholds’ typical clients are likely to lack insurance or to have challenges accessing care with the government insurance that they do have. In some ways, my work on the Thresholds board may seem a world far apart from those seeking to navigate care with, say, employer-based insurance.
On a practical level, there are barriers to accessing mental health care for nearly everyone. A friend of mine talked about the insights gained when two people compare perspectives from looking at the same valley from two different mountain tops. And so it is for me with Thresholds. While the specific challenges for any individual may be different, patterns emerge that we can work on together, such as: too few specialty-care clinicians, help for someone in treatment to manage the rest of their life while getting the care they need, and the important role that friends and family can play.
6. You also serve as a consumer representative to the National Association of Insurance Commissioners. What does it mean to bring the patient’s voice into rooms where insurance policy actually gets shaped?
The role of consumer representative to the NAIC creates opportunities to share, though perhaps more importantly, to listen.
State insurance regulators have box seats to the challenges facing consumer access to health care and the limitations of federal and state laws to enforce insurance company obligations to care. Being in the room with state regulators results in my hearing stories from around the country about insurance company barriers to care. Those stories help us to identify new resources that we can develop that can make a difference.
7. What is the thing you think we’re most missing in the conversation about mental health care right now?
There, but for the grace of God, go I.
I mean, the challenges of mental health and substance use disorder care touch pretty much everyone. These are not unusual conditions affecting people we don’t know.
Our thinking about how to ensure access to care is important for all because, in our lifetimes, it is likely to affect us or someone we care about. We need to approach it that way.
8. What do you want people to know about Cover My Mental Health, and how can individuals or organizations get involved?
When people learn about Cover My Mental Health, we ask that they share our website link with friends, family, and neighbors. Someone they know may very well benefit right now from access to our resources.
On a national level, the challenges of accessible mental health care are staggering.
An estimated 50% of mental health patients and 75% of substance use disorder patients do not have access to care, according to SAMHSA.
And a survey by the American Psychiatric Association Foundation found that 51% of adults thought treatment would cost too much, and 35% thought insurance would not contribute enough to make treatment affordable.
According to our internal analysis, an estimated 15 to 22 million mental health claims are denied by private insurers each year.
Beyond sharing our link, we welcome collaboration with advocacy and clinical organizations. And as a nonprofit, we depend on contributions and welcome support that helps us to develop more resources and reach more people.