Final rules have been issued requiring insurers to provide mental health and substance abuse treatment in the same way medical and surgical benefits are provided, including co-pays, deductibles, number of appointments allowed and more. The new guidelines apply to almost all private insurance plans, with the exception of Medicare and Medicaid. This new coverage will open doors to many Americans who do not have access to mental health care, despite an obvious need for such care. Parents, who are often the first to identify the need for psychological treatment in their children, will have new options available for treatment. According to the Associated Press, more than 45 million US adults suffered from mental illness in 2011, but just over 17 million received treatment, pursuant to the 2012 report by the US Substance Abuse and Mental Health Services Administration.
There is an important distinction in coverage. The new rule does not require group health plans to provide mental health coverage. However, if plans do provide such coverage, the coverage cannot be more restrictive or more generous than the guidelines for other physical and surgical treatment.
With the Affordable Healthcare Act, many changes are being implemented relative to health care. It is imperative that you be aware of these modifications of care, both positive and negative, so that you can enter the doctor’s office or hospital fully prepared for the costs and services provided by your plan.
These issues are also very important to those going through divorce when one spouse will likely lose his or her coverage once the divorce is finalized. This time of flux in a person’s marital life requires concreteness in other life determinations. Know what coverage you are going to obtain and at what cost before you decide your health insurance coverage plan. Contact your Wisconsin divorce attorney for additional assistance.