Feds Make Positive Change to Mental Health Insurance Coverage

by Lesley Politi on October 8, 2008

Posted by Fred Schultz
Wednesday, October 08, 2008 1:32 PM EST

Congress recently required our nation’s health insurance companies to address mental health issues as real concerns. This is potentially very good news for everyone who suffers from depression or other types of mental health conditions, and good news for employers as well. Finally, people who struggle with mental health concerns will be able to receive the same level of treatment as someone who has a chronic heart condition, and will be able to maintain their level of productivity at work because, as with any other health-related condition, early detection and intervention by qualified professionals generally leads to a better outcome for the patient.

People struggling with depression or other such diseases have been treated in a dismissive manner, or worse, for far too long. It wasn’t more than a few decades ago that families would essentially turn an autistic child or a child struggling with paranoid psychozophrenia over as wards of the state. Finally, we as a society are beginning to come to the realization that mental health issues are not only real, but also treatable. To me, this new action by Congress is a very positive step in the right direction and will shine much needed light on this subject.

The bill does not require all insurance companies to cover mental health treatment. However, if an insurance policy offers some level of mental health treatment coverage, then it must be covered to the same degree that other physical ailments are covered. This would mean keeping co-pays and deductible the same, and providing total coverage limits at the same level. My guess is that we will see health insurance companies who write policies for large employers such as Indiana University begin to phase in this coverage and see how it goes, and then begin to expand the coverage in a more standard way thereafter.

“There’s no question that insurance companies have been discriminating against the mentally ill,” said Jill Taylor, president of the Greater Bloomington Area Affiliate of the National Alliance on Mental Illness. “I’m thrilled that this legislation will put an end to that.”

Taylor said most insurance plans have lifetime payout caps of $1 to $5 million for the treatment of physical ailments, but lifetime caps as low as $25,000 for treating mental illness.

The majority of mental health conditions are very treatable if a person has reasonable access to doctors, counselors, and prescription medication. As someone with a sister who struggles with mental health issues, I have seen dramatic positive changes when people have access to mental health professionals, compared with when they don’t.

The unfortunate reality is that many people cannot afford treatment without insurance coverage to pay for most or all of the care they need. Historically, health insurance companies have not considered mental health treatment as being on par with traditional physical conditions, and have provided far more limited coverage for treatment. Even when coverage existed, the co-pays and deductibles were much higher for mental health treatment, and the maximum lifetime benefit was so low that one hospitalization could wipe out the coverage entirely.

Often, this lack of proper care leads to the person not being able to cope with the normal daily stresses that come with any full-time job. Eventualy, many people, like my sister, end up not being able to keep their job and end up applying for disability benefits. Even worse, some people with serious mental health problems that go untreated simply slip through the cracks in our society and end up not only jobless, but homeless or in jail.

Let’s hope that this new regulation has a positive effect on every day people who struggle with mental health issues because, if it does, it will have a positive effect on all of us.


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