workplace tagged posts

What Can You Do If Your Mental Health Benefits Are Denied?

Carol McDaid
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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Doesn’t Health Insurance Have to Cover Mental Health Care? What the Mental Health Parity Laws Really Mean, Part 1

healthinsuranceCarol 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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Two Stories of Consequences of Not Having Insurance through Work

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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Labor Day Thoughts on Mental Health Policy and the Workforce

Care for Your Mind

young woman in computer lab

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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What’s standing in the way of mental health recovery?

Paolo del Vecchio, M.S.W.
Director, Center for Mental Health Services
Substance Abuse and Mental Health Services Administration (SAMHSA)

Yesterday, Paolo del Vecchio told his personal recovery story and shared a set of elements that help define recovery. Today, he puts recovery into perspective with health reform.

Opportunities for Recovery under the ACAdelvecchio

To recover, individuals need access to quality, affordable health care and mental health services. The Affordable Care Act (ACA) expands mental health and substance use disorder benefits and parity protections to an estimated 62 million Americans and heralds a new era of hope for people with mental illnesses.

Beginning January 1, 2014, millions of uninsured Americans with mental health and substance use conditions will have access to health insurance coverage, many for the first time. In addition, thanks to the new health care law, beginning in 2014, insurers will no longer be able to deny anyone coverage because of a pre-existing mental health condition. Individuals will be able to sign up and enroll for insurance beginning in October of this year. People should go to www.healthcare.gov to find info on how to enroll.

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Six Resources for Workplace Mental Health

young businessman under stress, fatigue and headacheIn this week’s posts, Clare Miller of Partnership for Workplace Mental Health outlined why employers should pay attention to mental health in the workplace and offered some examples for how businesses can address mental health with their employees.

Today we offer some other ideas, programs, and information sources for employers who want to address mental health in their workplace.

  1.  Cost of Mental Health Training is a free webinar for human resources and employee assistance program professionals from Families for Depression Awareness
  2. Families for Depression Awareness also participates in the Massachusetts Workplace Mental Health Initiative, which offers company-specific workplace mental health programs to Massachusetts businesses at no charge. These include the Coping with Stress and Depression workshop for employees, online mental health screening from Screening for Mental Health, and training for managers from CMG Associates

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Policy in Practice: How Companies Can Address Mental Health

Clare Miller

Clare Miller
Director, Partnership for Workplace Mental Health

Employers who seek to address mental health issues in the workplace have a daunting task. After all, a comprehensive mental health workplace program could include the following:

  • developing a mental health policy that complies with federal and state law
  • implementing an employee assistance program
  • training managers to recognize mental illness and make referrals
  • offering mental health wellness programs, such as stress reduction and mental health awareness trainings and mental health screening tools
  • supporting employees’ health care needs, including providing adequate health insurance and allowing treatment-related time off
  • addressing employees’ concerns about their co-workers, including providing support services in the event of a mental health-related emergency or death (e.g., attempted or completed suicide)
  • communicating with employees about mental health to allay their concerns about job loss, stigma, etc., and encourage them to get help

The good news is that there are a number of programs and resources to help employers address their workplace mental health needs. Today, we look at two companies that have successfully introduced mental health programs, and Clare Miller shares information about Right Direction, a new program from The Partnership for Workplace Mental Health and Employers Health.

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Good Business Cents: Mental Health in the Workplace

Clare Miller

Clare Miller
Director, Partnership for Workplace Mental Health

Organizations like the Partnership for Workplace Mental Health and Families for Depression Awareness have long advocated for employers to address mental health in the workplace, citing both visible (e.g., disability payments) and hidden (e.g., lost productivity) costs of depression among employees. As we have previously discussed on this blog, the Affordable Care Act (ACA) requires that mental health care be included in health care coverage. As the ACA carries an affirmative obligation for certain employers  (50 or more employees) to provide health insurance, employers now have the opportunity to impact employees’ mental health broadly through proactive wellness programs and individually through their employee assistance plans and ultimately their health insurance programs.

In this post, Clare Miller explains the essential role of employers in advancing mental health and—even apart from the ACA—the critical reasons for employers to address the mental health needs of their employees.

Employers are an important constituency to engage in advancing mental health in the United States given their power in affecting how much and what kind of care employees and dependents actually receive. Indeed, about 157 million Americans receive coverage through employer-sponsored health insurance.

Employers are getting more involved in healthcare because many realize that employees are their most important asset—their human capital. They’re also focused on healthcare because it is such an enormous expense, as evidenced by the oft-quoted fact that General Motors spends more on healthcare than on steel.

Many employers realize that they can use their purchasing dollars to leverage the healthcare system to demand better quality. And demanding it they are; employers are pushing strategies such as value-based purchasing and outcomes-based contracting. They are aligning incentives to produce better outcomes, as in the case of value-based benefit designs, where copayments might be lowered or eliminated to encourage people to access care and services to manage chronic illnesses.

One of the first examples of this approach was focused on diabetes management. A large employer eliminated the copayments associated with diabetes medication after realizing that high cost-sharing was leading workers to forgo medication, which led to increased hospitalization costs. In response, the employer aligned incentives to be sure that workers could afford the treatment to appropriately manage their condition. Importantly, they married this strategy with others, such as patient education about diabetes management.

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