Inpatient 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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Poll: Reaching the 190-Day Limit

In yesterday’s Expert Perspective, Mark Covall called Medicare’s 190-day lifetime limit on inpatient psychiatric hospital services “arbitrary and medically irresponsible.”

Today, we want to hear from you! To better understand how the 190-day limit affects you and those you love, we want to know:

 

[poll id=”3″]

 

Vote in the poll and share your personal experiences in the comments below!

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Arbitrary and Medically Irresponsible: The 190-Day Limit

Mark J. Covall
President and CEO, National Association of Psychiatric Health Systems

Medicare denies specialty inpatient care for mental illness but not any other medical condition.

stockvault-stop-sign103079Over the past few years, we’ve made great strides in eliminating barriers to mental health treatment. In 2008, Congress passed the Mental Health Parity and Addiction Equity Act, which requires private insurers to cover mental health and addiction treatment at the same level as other medical disorders.

However, lawful discrimination against mental illnesses still exists for seniors and disabled adults who receive benefits through Medicare.

That’s because Medicare beneficiaries have a lifetime limit of 190 days of inpatient psychiatric hospital care. There is no such lifetime limit for any other Medicare specialty inpatient hospital service.

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