In reverence to National Mental Health Month, sponsored by the National Mental Health Association (www.nmha.org), Wellness News You Can Use is offering a call to action!
According to a recent report by the National Alliance on Mental Illness (NAMI), Health insurance plans are falling short in coverage of mental health and substance abuse conditions as compared to other health conditions. The report (http://www.nami.org/About-NAMI/Publications-Reports/Public-Policy-Reports/A-Long-Road-Ahead/2015-ALongRoadAhead.pdf) was released in early April, 2015.
The report surveyed 2,720 consumers, and 84 insurance plans in 15 states. While progress is being made after a 2008 law requiring some employer-sponsored plans to offer equal mental and physical coverage, there is still a great deal of work to do, according to Mary Giliberti, Executive Director of NAMI.
The report findings include the following:
- More mental health providers in health insurance plans are needed.
- Substance abuse treatment needs to be taken more seriously by insurance providers (Plans under the ACA actually had a higher rate denials).
- Barriers to mental health medication coverage needs to be addressed.
- The cost of drugs and co-pays needs to be addressed.
- Consumers need better information related to mental health coverage.
What can you do as a consumer?
- Look at mental health coverage before signing up for a plan under the ACA.
- Ask your employer about all coverages under your health plan and question coverages that do not exist or that are not adequate.
- If you have a claim that is denied, ask for clinical criteria used to approve or deny a claim.
- If you think the 2008 parity law that required equal coverall of medical and mental claims for come employer plans has been violated, say something.
- Ask for updated lists of mental health providers from your insurance company.
Write to your congressional representative and advocate for the U.S. Department of Health & Human Services to require all health plans to provide clear, accessible, and comparable information about benefits. In addition ask Congress and the Executive Branch to work together to decrease out-of-pocket costs under the ACA for low-income consumers.
Let’s all be well together!