Understanding Physical Health and Mental Health Insurance
By Carol Miller; RN, MBA
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There is a difference between the benefits covered under medical insurance compared to those covered under mental health benefits.
Mental Health Parity Act
There has always been a disparity resulting in caps on the annual number of visits allowed, higher co-pays, higher deductibles, and reduction of covered benefits such as partial hospitalization and number-of-treatment limits for mental health. Congress touched on this issue in 1996 with the Mental Health Parity Act. This federal law prevented group health plans from placing annual or lifetime dollar limits on mental health benefits that are lower¾less favorable¾than annual or lifetime dollar limits for medical and surgical benefits.
Group Health Plan Exclusions
However, the law did not require group health plans and their health insurance issuers to include mental health coverage in their benefits package¾it only applied to group health plan insurances that already did include mental health benefits in their benefit package.
MHETA Attempts at Correction
In 2003, Senators Pete Domenici, Edward Kennedy, and Representatives Patrick Kennedy and Jim Ramstad introduced S. 486 and H.R. 953, called the Mental Health Equitable Treatment Act. In March 2005, the Mental Health Equitable Treatment Act [MHETA] was passed and with the passage of this bill a loophole – insurers may no longer arbitrarily limit the number of hospital days or outpatient treatment sessions for people in need of mental health care – was closed.
Assessment
Nevertheless, even though states are encouraged by the government with this new bill to enact stronger parity laws, the final decision of parity still rests with the states. Many states have not enforced the law and therefore, insurers may still be inclined to limit
Conclusion
And so, your thoughts and comments on this Medical Executive-Post are appreciated. Why the mental versus medical health care insurance disparities?
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Filed under: Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters | Tagged: Health Insurance, insurance, insurance agents, mental health, Mental Health Equitable Treatment Act, mental health parity, MHETA | 8 Comments »