Monthly Archives September 2013

Carol McDaid
Winning strategies for filing a mental health insurance coverage grievance

CFYM Note: This is the last in the series by Carol McDaid on your rights with regards to mental health insurance parity laws and expanded coverage under the Affordable Care Act. Tuesday’s post provided an overview of what types of denials to look out for. Today, Ms. McDaid tells readers how to file a grievance for denial of mental health insurance coverage.

When should I file an appeal

Mental Health America compiled this list of questions to help you understand if you should appeal a coverage denial. At first glance, the questions may seem to require a sophisticated understanding of your plan and the law, but you can simplify it this way: If the answer is YES to any of the following questions, the plan is most likely not in compliance with the new laws.

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Carol McDaid
Parity Implementation Coalition

Follow these practical steps to win your appeal.

CFYM Note: Last week, Carol McDaid answered the question, “Doesn’t health insurance have to cover mental health care?” She also described steps to make sure you’re getting all the health care benefits you should. This week, Ms. McDaid covers what the mental health parity law means for you when you don’t get the benefits you’re entitled to.

From promise to reality

The fact that we now have two federal laws requiring mental health parity is cause for celebration—both for those of us who spent years advocating for the laws and those of us, me included, who have been denied coverage by our insurance plans.

The Mental Health Parity and Addiction Equity Act was signed into law in 2008. The Affordable Care Act goes into effect January 1, 2014, and will require more plans, including those in the newly created health insurance exchanges, to offer mental health parity. (Read more about the laws in Part 1 of this series.)

The federal laws are on top of state laws that exist in approximately 40 states to protect people from being denied mental health benefits through public and/or private employer-sponsored health insurance. (View a chart of state mental health parity laws from the National Alliance on Mental Illness.)

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Carol McDaid
Parity Implementation Coalition

CFYM Note: This is the second in a series of posts by Carol McDaid about mental health insurance parity and coverage rights under the Affordable Care Act (ACA). In the first post on Tuesday, Ms. McDaid advised us to learn about the law and be alert for upcoming changes. Remember, the health exchanges open for business on October 1.

Study your mental health care benefits and know your options

Whether you are purchasing insurance for the first time through one of the new health exchanges, interested in changing coverage during open enrollment, or simply frustrated with your mental health coverage, now is the time to become an informed, empowered, and vocal consumer. You need not wait for the MHPAEA final rule or the ACA’s effective date to understand how mental health parity laws can best serve your health needs. If you are engaged now, you are more likely to be prepared for any inequities or discrepancies you might encounter.

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Carol McDaid
Parity Implementation Coalition

CFYM Note: Many people wonder if their health insurance will cover costs for mental health hospitalization, therapy and medication. Read this first post in a series by Carol McDaid that explains your rights concerning equal insurance benefits in relation to physical and mental disorders.

Hint: Our work isn’t over

As a person living in recovery, I know firsthand the struggles people face when seeking mental health and addiction benefits. I understand what it’s like to be sick and in desperate need of treatment, told by my employer I had to go to treatment, but denied care by an insurance company.

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Shortage of mental health care providers

In Tuesday’s expert perspective, Dr. David Baron provided insights into innovative treatment models that have been implemented throughout the country. These models range from rural areas in West Virginia to large urban cities such as Philadelphia and seek to provide broader access to mental health services. At first blush it might appear that these two geographic locations have little in common in regards to access to mental health care...

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David Baron, MSED, DO

Professor and Vice Chair, and Chief of Psychiatry, University Hospital, Keck School of Medicine, University of Southern California

Care For Your Mind: As the provisions of the Affordable Care Act are implemented, what are the big changes you see for mental health care?

David Baron: Mostly, they are positive changes. More people will receive services whether under expanded Medicaid or purchasing insurance: this will enable them to seek care that they might not have had previously. The key will be making sure there are enough professionals to provide the care that people need and, of course, helping people to understand what kind of care they are entitled to.

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On Tuesday, inspired by Labor Day, we looked at three mental health policy issues for employees. One of those was the declining number of people who have health insurance through their work.

What are the ramifications for people who do not have employer-sponsored health insurance?

Today, two members of the CFYM community describe their struggles to access mental health care services in the absence of employer-sponsored health insurance. After her health insurance through COBRA ran out, Janet faced the prospect of highly-restrictive coverage, then no coverage...

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Care for Your Mind

As we return from the Labor Day holiday and our annual tribute to the contributions of workers to the strength, prosperity, and well-being of our country, it’s fitting to take a quick look at mental health policy issues for employees. The Mental Health Parity and Addiction Equity Act of 2008 and the Patient Protection and Affordable Care Act of 2010 (ACA) presented new opportunities for people to receive mental health care from their employer-provided health coverage. The Mental Health Parity law attempts to level the field between medical/surgical health care and care for mental health and substance use disorders, while the ACA aims to open access to affordable health care, including behavioral health care services, for more people. Both of these laws come into play, in part, through employees’ health insurance benefits.

Fewer people are getting health insurance through work.

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