Health insurance deductibles tend to be something we think little about until medical bills start showing up. At that point, even those who find their monthly premium payments somewhat manageable may feel financially strained as they pay for healthcare fully out of pocket until they meet their plan deductible.
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Open enrollment for 2018 individual health insurance plans may not begin until November 1, 2017, but insurers need to file premium rates for Obamacare exchange plans by June 21. But under what context are they filing them: a continuation of Obamacare or something else?
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Congratulations, college graduate! You’ve earned your degree and accepted your diploma. Now it’s on to the next thing, whatever that might be. If someone asked you to list the key concerns occupying your mind right now, you might include looking for work, finding a place to live, and figuring out a way to pay off your student loans as soon as possible. Don’t forget about securing health insurance coverage.
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Mental health illnesses and substance use disorders touch many lives, both directly and indirectly. An estimated 1 in 17 Americans face a serious mental health illness, and more than 1 in 7 Americans ages 12 and older have a substance abuse problem.1,2
Recovery and access to care play an important role in these lives. According to the Substance Abuse and Mental Health Services Administration, in recent years, a focus on recovery has “signaled a dramatic shift in the expectation for positive outcomes for individuals who experience mental and/or substance use conditions.”3 SAMHSA goes on to state, “Recovery is built on access to evidence-based clinical treatment and recovery support services for all populations.”
It is said that Obamacare is helping expand needed mental health and substance abuse coverage to those who need it. At MentalHealth.gov, the U.S. Department of Health and Human Services, “The Affordable Care Act offers one of the largest expansions of mental health and substance use disorder coverage in a generation.”4
Here are four ways the healthcare reform law is working to help provide more Americans with access to mental health and substance use coverage:
Health insurance companies can no longer deny you major medical insurance coverage or charge you more based on preexisting conditions; this includes mental illness and substance abuse.
Most individual and small employer health insurance plans must cover mental health and substance use disorder services as well as rehabilitative and habilitative services.
These services are among the Affordable Care Act’s 10 essential health benefits, which major medical health insurance plans offered on and away from the state-based and federally facilitated exchanges.
Essential health benefits cannot be subject to annual or lifetime dollar limits.
Major medical health insurance plans sold on and away from the state-based and federally facilitated exchanges must include certain free preventive services. That means insured individuals can access them for no additional cost beyond their monthly premium—even if they haven’t met their deductible.
Mental health and substance abuse services included in this free preventive care are as follows:
Building on the Mental Health Parity and Addiction Equity Act of 2008, major medical insurance plans sold on and away from the state-based and federally facilitated exchanges must provide certain parity protections.
This generally means that limits applied to mental health and substance abuse services cannot be more restrictive than those applied to medical and surgical services.8 This includes financial, treatment and care management limits.
As part of the healthcare reform law, these parity protections are extended to an estimated 62 million Americans.
Medicaid, the Children’s Health Insurance Program (CHIP), and Medicare all cover some mental health services. If you are insured through one of these programs, it is important to check with that program to confirm specific benefits.
If you have questions about mental health and substance use disorder benefits covered by your health plan, contact your insurance company. It is always important to check with your health insurance company to verify your health insurance benefits, whether you have job-based coverage, enroll in a plan sold through your state’s state-based or federally facilitated exchange, or purchase a health plan in the private marketplace.
Originally posted September 29, 2015
HealthCare.gov. “Mental Health & Substance Abuse Coverage.” https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/
Substance Abuse and Mental Health Services Administration. “National Recovery Month.” http://www.recoverymonth.gov/
U.S. Department of Health & Human Services. “Health Insurance and Mental Health Services.” http://www.mentalhealth.gov/get-help/health-insurance/
1 Miller, Alan B. “Obamacare Has Been a Huge Help for Mental Health Care.” CNBC. Jan. 26, 2015. http://www.cnbc.com/2015/01/26/obamacare-has-been-a-huge-help-for-mental-health-care-commentary.html
2 CASAColumbia. “Addiction: The Unmet Need.” Last updated July 15, 2015. http://www.casacolumbia.org/about
3 Substance Abuse and Mental Health Services Administration. “Recovery and Support.” Last updated Oct. 29, 2014. http://www.samhsa.gov/recovery
4 U.S. Department of Health & Human Services. “Health Insurance and Mental Health Services.” http://www.mentalhealth.gov/get-help/health-insurance/
5 HealthCare.gov. “Preventive Health Services for Women.” https://www.healthcare.gov/preventive-care-benefits/women/
6 HealthCare.gov. “Preventive Health Services for Adults.” https://www.healthcare.gov/preventive-care-benefits/adults/
7 HealthCare.gov. “Preventive Health Services for Children.” https://www.healthcare.gov/preventive-care-benefits/children/
8 HealthCare.gov. “Mental Health & Substance Abuse Coverage.” https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/
About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual specialty benefit products, including disability, supplemental health, pet, and group life insurance through its subsidiaries since 1980. The IHC Group owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), and IHC Specialty Benefits, Inc., a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers..
About IHC Specialty Benefits, Inc.
IHC Specialty Benefits, Inc. (IHC SB) is a technology-driven, full-service marketing and distribution company that focuses on small employer and individual consumer products through general agents, telebrokerage, advisor centers, and private-label arrangements. IHC SB conducts business under the following brands: Healthedeals.com; Health eDeals Advisors; Aspira A Mas; and PetPlace.com. For more information about IHC SB visit http://www.ihcgroup.com/companies.
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