After Newtown Shootings, Questions About Mental Health Insurance Coverage

[ehrnst]

In his speech at the memorial service for the Newtown victims, President Barack Obama included mental health in calling for a national response to the massacre, a conversation that so far has focused on gun control. "I will use whatever power this office holds to engage my fellow citizens -- from law enforcement to mental health professionals to parents and educators -- in an effort aimed at preventing more tragedies like this," the president said.

On Monday White House spokesman Jay Carney pointed to the federal health law as evidence that the administration has already started to tackle the issue. Mental health issues are "clearly a factor that needs to be addressed in some of these cases of horrific violence," Carney said. "Obamacare, if you will, has ensured that mental health services are a part of the services" provided under the health law.

Insurance coverage for mental health treatment has long been spotty. More than a quarter of U.S. adults have a diagnosable mental health problem in any given year, but fewer than half receive treatment. While the Affordable Care Act, along with the Mental Health Parity Act of 2008, go a long way toward assuring coverage for most Americans, some gaps persist. There are questions, for example, about just what counts as equivalent treatment under the parity law, and whether it's being fully enforced.

http://www.kaiserhealthnews.org/Stories/2012/December/18/Mental-Health-Insurance-Coverage-Questions-After-Shooting.aspx

[frazzled]

1. Coverage is not the entire problem

Even for people with excellent health insurance coverage, it can be difficult to find a psychiatrist who will take it. In the larger cities especially, many psychiatrists simply will not take it. (Psychologists and other practitioners mostly do, but I'm talking doctors with medical degrees here).

From a study from last year ("Psychiatric Care Hard to Get, Even for the Insured&quot :

"According to a new study by Harvard researchers, access to outpatient psychiatric care is extremely limited here, and it doesn’t make much difference if the patient has top-notch health insurance or is suffering from a dire mental illness. As part of this “simulated patient” study, published Thursday as a letter in the Annals of Emergency Medicine, researchers posed as severely depressed patients with excellent health insurance and tried to get an appointment for psychiatric care at a facility in downtown Boston. But of the 64 facilities they called, they were only able to get 8 appointments, and only 4 of those were within two weeks."


http://commonhealth.wbur.org/2011/07/psychiatric-care-hard-to-get-even-for-the-insured-study-finds

[Throckmorton]

2. Very true, very true.

My daughters Autism specialist, and absolutely wonderful Psychiatrist, doesn't take insurance of any kind, and I only get 50% of what he charges back when I file it as out of network. When both of my children were seeing him, it cost me over $300 per month out of pocket.