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We’re Still Struggling To Achieve Mental Health Parity

We’re Still Struggling To Achieve Mental Health Parity

We’ve written in the past on the Mental Health Parity Act of 2008, the law that requires that insurance providers treat mental health conditions with the same policies and payment requirements as they would for other medical conditions. The law has been in effect for nearly 10 years – have insurance companies really changed their practices to comply?


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That's the question NAMI set out to answer. In a report that was released last week, NAMI released the results of client surveys that asked respondents to answer key questions about their mental health coverage. And while more obvious parity requirements, such as requiring higher co-pays for mental health care, appeared to be non-issues in the report, more subtle issues of parity appeared again and again.

The primary concern found in this report was that those seeking mental health care were more often unable to find an in-network provider that accepted their insurance, thus requiring them to go out-of-network if they chose to pursue care. Since out-of-network providers require a higher share of cost for patients, these clients are still paying more for therapy and other mental health services than they would otherwise. While insurance companies are still technically in compliance with the parity law, the overall intent of the law – equal access for mental health services – still remains unachieved. This is highlighted by the fact that those seeking mental health care were more likely than those seeking medical care to go out-of-network. Even more disturbing was the finding that about one-third of patients seeking mental health care were unable to find either an in-network or out-of-network provider, which required them to pay for care without the help of their insurance.

There are also some more obvious ways insurance companies are side-stepping the requirements of the parity law, specifically around provider reimbursement rates. The report found that mental health and substance abuse providers were reimbursed 20% less than primary care providers for the same services. Thus, without higher reimbursement, insurance companies are unable to recruit mental health providers who are willing to contract with them, and patients are left without in-network options for care.

So what’s the solution to this? Aside from advocacy and encouraging elected officials to hold insurance companies accountable to the requirements of the law, there are a few things clients can do when they run into problems accessing care through their insurance company:

  • Contact all in-network and out-of-network providers that are within a reasonable distance to inquire about services. If there are providers and they aren’t accepting new patients, explain to them the circumstances and request to be wait-listed – they may be willing to work with you sooner if they understand your issues with access and your current condition.
  • Contact your insurance company to request assistance or to make a complaint about the lack of providers that your coverage allows you to see.
  • Seek out alternative forms of affordable care. Whether you choose to replace your insurance provided care altogether or use an alternative service until you can receive insurance-covered treatment, there are options available. For example, many people are choosing to use online therapy as an affordable treatment option through providers such as BetterHelp (a sponsor).

While the current state of mental health parity leaves a lot to work on, things are definitely better than they once were. Luckily, for those clients who still can’t access services through insurance, we also have the technology where online options are now readily available as well.



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Jennifer Novack
Posted on 12/04/2017 by Jennifer Novack

Jennifer is a writer for OpenCounseling. She has worked at a number of state and non-profit organizations, providing counseling, training, and policy development


 

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