C is for Coverage and Care for Mental Health Patients

Insurance companies love them or hate them, they are a necessary evil and that is never more evident than when it comes to mental health care.  The news is overrun with stories of people trying to find help only to be let down by their insurers or mental health facilities in general.

 

With the push for people to sign up with the Affordable Care Act (ACA), it has become evident, according to NAMI (National Alliance on Mental Illness) that there is a lack of providers in plans for mental health care.  The problem falls not only on the companies themselves, but in some cases the doctors as well.  There are many psychiatrists and psychologists that are not taking new patients with health insurance because they do not receive a high payment rate, add to that the number of sessions, appointments and paperwork, many independent doctors find it easier to shy away from the insurance all together. 

 

Mental health, when it comes to finding inpatient care is difficult.  A paper in Baltimore ran a story of a man in New York who died of an overdose after his admission to a treatment center was denied after it was deemed not medically necessary, within two months he was gone.  The system failed not only the young man, but his family as well. 

 

A personal experience showed me just how difficult it is to use insurance for psychiatric care.  I found out that my plan allowed only 30 days a year for inpatient care, for outpatient is approved only two facilities both of which would not accept me due to the fact I was not “sick enough.”  This series of events left not only me, but my doctors baffled as well and searching for ways to get me the assistance I needed and work around the obstacles that were thrown in our way.  The final outcome was not good; I came away with only appointments with my psychiatrist and psychologist, with those closely monitored as well as to the number of times I was allowed to go. 

 

Denial for mentalhealth care is higher than other type of medical care, leaving high out-of-pocket costs for patients when it comes to care and medications.  According to state and federal laws there is to be equal coverage for both mental health and medical conditions, costs should be no different between the two, though discrimination still exists, and surveys have shown that is much more difficult to find a mental health care provided than a medical doctor, with inpatient care be harder than for any other care. 

 

You get the basic idea of what not only United States, but countries around the world are facing when it comes mental health care.  It is not seen as medically necessary in most cases and until that change there will be more patients not finding the help they need at some of the most difficult times in their lives.