Are you confused about how mental health care services and mental health care insurance work together?
If you are — you’re definitely not alone. As the importance of self-care and improved mental health care are a few of the hot topics of the day — there’s no wonder that health insurance companies and major employers are making the investment into employee behavioral health care benefits.
In this article, we discuss the Mental Health Parity and Addiction Equity Act MHPAEA including who’s covered, who’s required to provide benefits and how substance abuse and drug addiction factor into the equal opportunity health care act.
Let’s start with the basic provisions of what the MentalHealth Parity and Addiction Act and what it covers.
The Mental Health Parity & Addiction Act (enacted in 2008 and amended in 2010) requires large employers who provide health insurance benefits to their employees to provide comparable benefits for medical and mental health care services under their group benefits plans.
A major component of the act changes how mental health care benefits are assigned. The MHPAEA federal law enacted in 2008 makes it possible for group health benefits plan subscribers to receive equal coverage for medical and mental health care. This includes all financial payments for deductibles, co-payments, and annual out-of-pocket limits.
Many employers (and employees alike) aren’t fully aware of the provisions included in the federal act that now offers coverage for mild to severe mental health treatments at the same coverage level as other medical health care based services.
Eligibility — So, who’s eligible for coverage under the MHPAEA? People Insured through their employer (or other large group health plans) are eligible for coverage under the act. People who are uninsured or underinsured (including those who qualify for state benefits like medicare or medicaid) can also receive mental health coverage under the MHPAEA.
An important change to the Parity Act happened in 2010. They amended the act in 2010 to include behavioral health coverage for individual insurance plans.
Want to learn if your employer covers mental health services under your insurance plan? Contact your insurance benefits provider directly to learn more about what type of coverage you have.
MHPAEA Benefits – Equal benefits with no lifetime limits for mental health disorders, mental illness, substance abuse disorders. People are eligible to receive medical/mental health treatment from licensed and board-certified providers in their state of residence.
Covered mental health services include – counseling, psychotherapy, medication management, referrals, case management.
Mental Health Services – With over 43 million people in the US suffering from mental health disorders annually, the MHPAEA was introduced at an opportune time. As we become more aware of the mind/body connection, we’re learning that mental health care and physical health are equally important.
Gone are the days where mental health is considered a secret or stigma. Under the MHPAEA, consumers, employees and employers alike are finally getting the mental health services they need.
According to the National Institute for Mental Health (NIMH), the following are statistics related to the prevalence of mental illness and mental health disorders in the United States.
The NIMH reports that at least 46.6 million adults in the United States live with mental illness annually.
(5) Common Mental Health Disorders In The United States,
- Anxiety – a nervous disorder characterized by severe anxiousness, unease, panic attacks, and compulsive behaviors.
- Depression – a medical condition that causes sadness and loss of interest in activities you used to enjoy. Also known as major depressive disorder (MDD).
- Post-traumatic stress disorder – a condition of severe mental and emotional stress in response to a traumatic event or psychological shock. They associate PTSD with sleep disturbances, flashbacks, and anxious behavior.
- *Bi-polar disorder – a mood disorder marked by periods of emotional highs and lows that vacillate between elation and depression.
- *Schizophrenia – a serious and long-term mental disorder characterized by faulty perception, inappropriate actions, and a fragmented mental state.
*Conditions marked with an asterisk are “severe or serious” according to medical and mental health professionals. Severe conditions require a higher standard of care that involves intensive monitoring, psychotherapy support, and inpatient hospitalization.
Serious mental health effects can limit or impair functioning and lower the quality of life of someone who has serious mental health issues. A person with mental health issues may have trouble concentrating, completing everyday tasks like self-care routines, and maintaining employment.
Who “Doesn’t” Benefit From The MHPAEA?
Self-Employed, Freelancers, Entrepreneurs, And Other Independent Workers May Not Benefit At This Time.
People who are self-employed won’t benefit from the MHPAEA. They don’t qualify for coverage under the federal parity regulations. Other mental health options for people who are self-employed can be found through free, reduced, and low-cost mental health care options.
Uninsured – People who opt for no health insurance coverage at all aren’t able to take advantage of the provisions included in the Mental Health Care Parity Act. This is because individuals with no insurance coverage aren’t eligible to receive services under an employer plan, individual plan, or state-sponsored plan.
If you find yourself in this situation, don’t be afraid to seek free or low-cost mental health care services from public health care clinics or online — instead of opting to bypass mental health care.
Upcoming: Free and Low-cost healthcare options for freelancers, self-employed writers, marketers, and small business owners.