Skip to comments.New Federal Rule Requires Insurers to Offer Mental Health Coverage
Posted on 02/21/2013 7:02:51 PM PST by Seizethecarp
The Obama administration issued a final rule on Wednesday defining essential health benefits that must be offered by most health insurance plans next year, and it said that 32 million people would gain access to coverage of mental health care as a result.
The federal rule requires insurers to cover treatment of mental illnesses, behavioral disorders, drug addiction and alcohol abuse, and other conditions.
Kathleen Sebelius, the secretary of health and human services, said that in addition to the millions who would gain access to mental health care, 30 million people who already have some mental health coverage will see improvements in benefits.
White House officials described the rule as a major expansion of coverage. In the past, they said, nearly 20 percent of people buying insurance on their own did not have coverage for mental health services, and nearly one-third had no coverage for treatment of substance abuse.
The rule says the new health insurance policies can be offered at four levels of coverage. Under the least generous policies, known as bronze plans, consumers will pay 40 percent of the costs of covered benefits, on average, and insurers will pay the rest. Under the most generous policies, known as platinum plans, consumers will pay 10 percent. The administration, however, declined to set a uniform national standard and allowed states to set many of the specific requirements.
Minimum benefits will vary from state to state, as each state will have a benchmark plan, reflecting coverage typically offered by employers. In more than 30 states, the benchmark, or standard, is an insurance plan offered by Blue Cross and Blue Shield.
Insurers in each state will generally be required to provide all benefits required by state laws adopted before Dec. 31, 2011.
(Excerpt) Read more at nytimes.com ...
I’ll bet the issue of who pays for this wasn’t addressed.
There is a shortage of shrinks and interest in this thankless pill-pushing profession is dropping.
A shrink that I know dumped a huge Medicare practice because he lost money on those patients. The onerous paperwork demanded on top of the threats of fraud prosecution and too little time allowed per patient.
So who is going to serve the 30 million new Medicaid and “exchange” patients?
Wow! The insurer picks up a whole 60 percent of the cost! That’s not an insurance policy, it’s a discount plan.
Everybody's insurance premiums are now going up yet again.
mental health insurers
Well...this will destroy health care even FASTER!!!
I see something more sinister...
Get everybody to declare they have a mental health issue to their doctors because inusrance will pay for it, then they will declare you a mental health risk and you wont be able to buy a gun!
WE are ALL going to be MENTAL cases soon....
Several major things happened in January. First, networks decreased contract rates for their providers so you’re going to see more providers not accept any insurance.
Second, if an insured person had more than themselves covered, all family members covered have to meet a huge deductible before anyone is covered. $1,200 deductible may not be quite so bad but if parents and one child are covered, suddenly you’re up to $3,600.
Third, the co-pay amount is often almost all of the negotiated contract rate. A patient one of my docs saw today for psychotherapy has insurance with a contract rate of $85, of which $75 had to be paid by the patient. Lot of paperwork to prepare and staff to pay in order to collect the additional $10. Doc is better off to see patient as private pay for $75.00.
So who is going to serve the 30 million new Medicaid and exchange patients?”
Exchange patients have a rude awakening ahead. Nobody is going to see them because there is not going to be any money. One of the problems with Medicaid patients, at least in our state, is that there are very few providers who accept this insurance.
You realize that health/mental health insurance will see even more price hikes. Thousands of dollars more annually for a family.
ObamaCare banned those plans with limited coverage that could be had cheap. Universal Studios had a plan for $18 a month that limited hospital stays at $5000. No longer an option, full coverage, no limit insurance for all whether you can afford it or not.
It is designed to crash the healthcare/insurance system. That is the only conclusion one can draw, and they have already gotten away with it.
Certainly the American Psychological Association has to bear a chunk of the responsibility for some of what has happened to mental health benefits. They pushed for “equality” with medical benefits. So they got equality but that pie is only so big.
But the goal of Obamacare is to make it financially impossible to operate a private-pay-only practice.
YEP...we will be going “off shore” for medical care soon...
Note to self: insurance companies pay for nothing; they either pass costs on to consumers or go out of business, both of which are the intent of Obamacare