Mental Health Benefits Author:    Posted under: Health InsuranceHealth Insurance questions answeredHealth Insurance Types

Mental Health services have always been a part of medical care. Unfortunately, discussions and debates have been going on regarding costs, coverage and availability of services. Unlike other health care services that are state mandated, there is no concrete law that requires coverage of mental health.  There is, though, a somewhat enacted law in almost all of the states but they vary and can be divided into three categories.

  • Mental Health Parity or Equal Coverage Laws: Simply put, this law demands that health care insurers extend the same coverage or benefits to mental illness, serious mental illness and substance abuse as for other physical diseases or illnesses. Visit limits, deductibles, copayments and lifetime and annual limits are also included as part of the benefits.

    The parity law has many variables that affect the level coverage. In Arkansas, they provide general and sometimes non-specific coverage. In other states, they limit the coverage to serious mental illness or biologically inherited diseases.  Some even include substance abuse in the coverage.

  • Minimum Mandated Benefit Laws: Unlike the equal coverage law, this type of law does not have the same level of coverage or benefits for mental illness, serious mental illness, substance abuse as physical illnesses. The difference may lie in the number of visits allowed or copayments, deductibles and annual limits.

    Some advocates feel that anything short of full parity or equal coverage can be labeled as discrimination while others think that this is better than no coverage at all. Having limited or minimum coverage the copayment can be as much as 50% and every visit will require a certain deductible.

  • Mandated Offering Laws: These laws do not require that benefits or coverage be provided at all. It can, however, do two things: it can demand that the insured be provided with coverage or benefit for mental illness, serious mental illness, substance abuse or combination of the three. The coverage can either be approved or rejected. In the event that the coverage is approved, expect higher or additional premiums. Second, this law can also require that if benefits will be given then it should be equal.

The state laws do not apply to federally funded programs such as Medicare, Medicaid, Veterans Administration and the like. On the other hand, many private health care providers offer mental health benefits on a voluntary basis. Some state laws do not consider Grief counseling as part of the covered benefit. But insurers can offer grief counseling as part of a standard mental health benefit package.

The understanding of mental health law can be daunting. If you or someone in your family requires such coverage or benefit, it is imperative that you seek counsel and advice from your local health center. If you have health care coverage, you can also consult with your health care insurance agency and find out what they can offer you.


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