It’s high time we need to be aware that Mental Health Insurance matters so much more. Mental and behavioral problems are widespread and serious in many countries especially in the U.S according to the National Alliance on Mental Illness. This certainly contributes to the doctor visits and hospital bills as well.its very important for one to have a proper health insurance in place which covers for mental health as well. Before the Affordable Care Act came in place such insurance covers were very isolated and inconsistent. Some of them used to cover a lot for mental health while others had no coverage at all. One of the many promising benefits in the Affordable Care Act is its mandatory requirement on covering mental and behavioral issues.
Why Mental Health Insurance?
As per the NAMI, 19.1% of U.S adults experienced mental illness in 2018 while 4.6 adults in the U.S suffered from serious mental illness which is 11.4 million people from the total population. When it comes to youth aged between 6 and 17 in 2016 16.5% were having mental health disorders and in 2018 again 9.2 million people which is 3.7% of the U.S population the adults experienced both a substance use disorder and mental illness. Well ,the good news is that ACA helps pay for the treatment. We need to consider mental health disorders are like any other health issues and that’s why mental health matters.
All the above said data found in 2018 had no coverage for the illnesses unfortunately. As per the ACA,when going for a health insurance covering for mental illnesses we must make sure it gives coverage for certain important aspects like behavioral health treatment such as psychotherapy and counseling, mental and behavioral health inpatient hospital services, substance use disorders treatment and any pre existing mental and behavioral health conditions. However the mental health insurance plans must be in equivalence with other health issues such as medical and surgical covers. It must not be restrictive alone.
As of 2014 when ACA was introduced , most of the health insurance plans including the individual and small groups, even the ones sold in the marketplace were also required to cover mental health and substance disorder services, says the U.S Department of Health and Human Services. There are employer based insurance coverage as well as individual coverage which includes mental health insurance.
Employer-Based Coverage : this is required to follow the ACA requirements regarding mental and behavioral health, including parity protection. Human and Health Services suggests you to look carefully at your plan application materials to see what coverage levels are there to meet all your needs and which benefits you may get. ACA however requires insurers to provide easy-to-understand summaries which includes mental health benefits.
If you do not get insurance through your employer or Medicare, the HHS suggests you to learn about cover given by Medicaid,Comprehensive Health Insurance Plan (CHIP) or the marketplace sources by visiting HealthCare.gov. Help is available if you try to find it.
When shopping for Mental Health Insurance coverage, there are a few important points to consider like, we really need to check the plan’s network of physicians and medications. Nathan Teater, Manager of IFP Sales , customer care and enrollment for eHealth said,“The biggest hiccup we find is ensuring your mental health doctor is in the network. Try to educate yourself on making sure your doctor is in the network,so you get reduced rates.” he also added “ Also make sure your drugs are covered under the plan you buy. Check the formulary list. Drugs can be quite expensive if not on the formulary.”
He strongly suggests to avoid short term plans,because they are not regulated by the ACA and therefore usually do not cover mental and behavioral health care, pre-existing conditions and medications. “Steer away from any short term plans,i never recommend these plans” says Teater.