Does Your Insurance Cover Mental Health Conditions?

In the US, insurance companies are already required to provide coverage for mental health disorders and mental care needs, much like they must provide cancer or diabetes care.  But according to a new study there seems to be a gap in how people suffering from a mental health condition are covered.

In a report from the National Alliance on Mental Illness, researchers revealed that the "health insurance plans are falling short in coverage of mental health and substance abuse conditions."

Jenny Gold of Kaiser Health News said in a new report that patients with mental care needs are having difficulty getting their treatment covered.

In the past, insurance companies had separate policies with higher premiums and copays for mental health services. Today, insurance companies are forced to include these treatments in one policy. In an effort to cut costs, insurance companies are using a "medical necessity" review before providing coverage. This is used as a delay tactic to help the insurance companies cut costs and delay any coverage for people seeking treatment for substance abuse or mental health disorders.

In response to the issue of distinguishing the need for physical or mental care, Clare Krusing from America's Health Insurance Plans said, "The plans have taken tremendous steps since the final rules came out to implement these changes and requirements in a way that is affordable for patients and again this goes back to the fact that we are at a point where health care costs continue to go up."

When consumers of the National Alliance on Mental Illness were asked about the care they are receiving, a majority reported that they were twice as likely to get rejected for their mental health care as they were for their physical health care.

As for Carol McDaid, an advocate who runs the Parity Implementation Coalition, people can bring a complaint if they feel like their insurance denied them help but the problem is it is hard to prove the violation.

"They end up with this perception that they have access to care, but when they're in a crisis for themselves or their loved one, lo and behold, the care's not available because of these cost-control techniques," McDaid says.

Some states are already taking measures to ensure that insurance companies get the medical care they need and some individuals have had to resort to the courts to settle their differences with the insurance companies.