Worried that women and providers are facing mounting insurance barriers when trying to access maternal mental health care, we recently asked our network to share their experiences navigating insurance coverage and policies. 

Below we analyse the 11 responses received thus far.  

We invite you, our readers, to share your experiences and challenges too. We will provide a periodic update as more responses are received. 

  • Respondents represented a wide geographic range across multiple states, including Nebraska, Oregon, Illinois, Washington, D.C., Maryland, Colorado, California, Florida, Indiana, Virginia, and Minnesota.
  • Respondents included mothers, therapists, doulas, lactation consultants, and advocates. 

While each situation was unique, the responses revealed several consistent themes: cost barriers, provider shortages, Medicaid coverage gaps, and administrative obstacles that delay or prevent care.

The Most Common Challenges Reported

Financial Burden with Accessing MMH Care

The most frequently reported issue was the financial burden associated with accessing maternal mental health care.

Many respondents described having insurance coverage on paper, but still being unable to afford treatment.

The reasons cited included: 

  • High deductibles averaging around $3,500
  • Therapy sessions that cost $200–$300 per week before their deductible is met.
  • Large co-pays for ongoing mental health treatment
  • Out-of-network denials and telehealth coverage limitations

Several respondents described what many referred to as the “gap” experienced by middle-income families: earning too much to qualify for Medicaid, but not enough to comfortably afford private insurance costs and high out-of-pocket medical expenses. Some families reported paying as much as $12,000 out-of-pocket for pregnancy and delivery-related care alone.

These financial realities often forced families to delay treatment, reduce therapy frequency, or forgo care entirely during pregnancy and postpartum recovery.

Provider Networks That Don’t Reflect Reality

Not surprisingly, another major theme was the difficulty of finding providers who both specialize in maternal mental health and accept insurance.

Respondents reported:

  • Long waitlists for in-network specialists
  • Insurance directories that were outdated or inaccurate
  • Providers who stopped accepting insurance because reimbursement rates were too low
  • Credentialing delays that prevented providers from joining insurance networks

Some respondents specifically noted that insurers reimburse maternal mental health specialists at rates far below market value, making it financially unsustainable for providers to participate in-network.

Even when families had insurance coverage through large systems, they often struggled to access timely care. Several participants described waiting months for appointments while experiencing worsening postpartum depression, anxiety, OCD, or other perinatal mental health conditions.

Postpartum Coverage Gaps and Continuity of Care

Several respondents described challenges accessing consistent mental health care during the postpartum period, particularly for families relying on Medicaid or navigating insurance transitions after childbirth.

Respondents described broader postpartum access barriers, including difficulty finding providers who accept Medicaid, disruptions in care after insurance changes, and limited availability of postpartum mental health services.

Participants also highlighted how changes in employment or insurance plans during the postpartum period can interrupt long-term therapeutic relationships, forcing mothers to stop seeing trusted providers during a particularly vulnerable time.

Together, these responses underscore the importance of continuous postpartum coverage and stable access to maternal mental health care beyond pregnancy and delivery.

Administrative and Technology Barriers

One respondent described the frustration of trying to access urgent care through automated scheduling systems and AI-driven phone trees that made it nearly impossible to speak with a real person during a mental health crisis.

While technology can improve efficiency, respondents emphasized that maternal mental health crises require timely human support and flexible access to care.

What Respondents Believe Needs to Change

Participants repeatedly emphasized several policy and system-level recommendations:

Treat Childbirth as Essential Care

Many respondents argued that pregnancy, childbirth, and postpartum care should be fully covered without burdensome out-of-pocket costs.

Improve Network Adequacy Standards

Families need accurate provider directories and realistic access to maternal mental health specialists, not simply lists of unavailable providers.

Redefine “Affordable” Insurance

Respondents noted that monthly premiums alone do not reflect affordability when deductibles and out-of-pocket maximums remain financially devastating.

The experiences shared confirm a larger national issue: maternal mental health care remains difficult to access even for insured families.

Coverage gaps, unaffordable costs, provider shortages, and administrative barriers continue to prevent parents from receiving timely support during pregnancy and postpartum recovery. For many respondents, insurance coverage existed in theory, but not in practice.

The Policy Center is supporting policy reform efforts that improve access to affordable health insurance coverage and health care. This includes: 

  • Submitting comments to the Senate Finance Committee on solutions to rising health care costs
  • Supporting legislation to ensure mothers can access maternity care without out-of-pocket costs
  • Encouraging CMS address high out-of-pocket costs and restrictive enrollment windows for Affordable Care Act insurance plans via submitted comments 
  • Meeting with CMS on streamlining the prior authorization process that can interfere with accessing MMH- specific inpatient or intensive outpatient care or  PPD-specific drug treatments
  • Urging state Medicaid agencies and the Centers for Medicaid and Medicare Services (CMS) to implement policies ensuring that the Medicaid work requirements exemption process does not impact access to perinatal coverage and care 

With readers’ support in providing stories, insights and financial support, we will continue to elevate a framework for affordable and accessible care in America.