Two federal laws that provide better insurance coverage for more people with mental health and substance abuse conditions are just beginning to take effect, and advocates describe the changes as a huge win for consumers that will greatly improve treatment.
As anyone who has ever sought help for addiction, depression or any other mental illness knows, insurance coverage is often skimpier than for a physical malady. Plans typically limit the number of therapy visits they’ll pay for, and they may also impose separate deductibles for mental health and substance abuse services and require higher out-of-pocket contributions from patients as well.
Under the Mental Health Parity and Addiction Equity Act, which took effect this year, the mental health and substance abuse benefits that a health plan provides have to be just as generous as its coverage for medical and surgical treatments. The law does away with different co-payments, deductibles and visit restrictions.
“These financial equalizers will be very helpful to families that have not been able to access care before,” says Katherine Nordal, executive director for professional practice at the American Psychological Association.
Plans are not required to provide mental health or substance abuse coverage, however, and they can also determine that they will not cover specific disorders. The regulations on parity went into effect July 1 , so in most plans the changes become effective when they renew their coverage after that date.
The parity law – which was championed by former Sen. Pete Domenici, R-N.M., and the late Sen. Paul Wellstone, D-Minn. – doesn’t apply to plans at companies with 50 or fewer employees or to individual health insurance policies. The new health-care overhaul law, however, will pick up the slack. Under the law, health plans sold through the state-based insurance exchanges that will begin offering coverage in 2014 must include mental health and addiction benefits, and the benefits must be on a par with a plan’s medical benefits. The exchanges will be open to individuals and to small businesses with 50 or fewer employees.
Reported by Michelle Andrews
Submitted by Anna