The Forum Site - Join the conversation
Forums: Society & Lifestyles:
Law

Law Requiring Parity between Mental and Physical Health Insurance

Reply to Topic
AuthorMessage
Jihadista On July 04, 2014

Deleted



Orange,
#1New Post! Dec 06, 2013 @ 05:05:50
Federal laws, or possibly regulations written to inforce the law, requires that if a health plan offers a benefit for mental health, then the health plan must cover them to the same extent that they cover medical and surgical care.

The law prohibits treatment limits and copayments or deductibles for mental health that are more restrictive than a plan's medical coverage.

Plans need not cover mental health benefits, but if they do, they must cover inpatient and outpatient services, emergency care and prescription drugs.

Health plans may treat preferred providers differently than nonpreferred providers, so a consumer could have higher copays for nonpreferred providers in their insurer's network for mental health outpatient services than for preferred providers,.

State parity laws that are more stringent than federal parity laws are not pre-empted. For example, some states' parity laws require coverage of particular services or benefits on top of the federal requirements. For example, some states require autism coverage.

Autism coverage? I don’t know autism has a treatment. I must wonder what that treatment might include.

NPR
Electric_Banana On about 4 hours ago




, New Zealand
#2New Post! Dec 06, 2013 @ 05:33:44
@Jihadista Said

Federal laws, or possibly regulations written to inforce the law, requires that if a health plan offers a benefit for mental health, then the health plan must cover them to the same extent that they cover medical and surgical care.

The law prohibits treatment limits and copayments or deductibles for mental health that are more restrictive than a plan's medical coverage.

Plans need not cover mental health benefits, but if they do, they must cover inpatient and outpatient services, emergency care and prescription drugs.

Health plans may treat preferred providers differently than nonpreferred providers, so a consumer could have higher copays for nonpreferred providers in their insurer's network for mental health outpatient services than for preferred providers,.

State parity laws that are more stringent than federal parity laws are not pre-empted. For example, some states' parity laws require coverage of particular services or benefits on top of the federal requirements. For example, some states require autism coverage.

Autism coverage? I don’t know autism has a treatment. I must wonder what that treatment might include.

NPR



Autism = Care Provider coverage. The person can't manage on their own.

And I believe that not only including mental health coverage (something that has been majorly needed for years now) ($300 a month for Risperdone - Trust me they're not dodging the meds because they believe they're mind-wipe drugs to shut them up ) I also don't believe that coverage will be in use for very long - It only takes the right person to offer advice in a manner comprehensive to the patient where something clicks and that patient proceeds to mend themselves (I'm talking about schizophrenia and depression whose cure relies heavily on the individual's cognitive practices. ).

First I had a counselor tell me and then a psychiatrist many years later.

They both said the same thing but the second time made sense.

"Congratulations you are now on the same page as the rest of us but your new perception of reality is not an issue unless it causes you grief or results in irrational decision making )."

Most people just need to find others who are completely aware of what they are on about and then help offer different perspectives such as "Left in the dark" can be seen as "Provided an advanced challenge."

Or "Well, no - if you suspect others can sometimes overhear your thoughts that isn't delusional but it is still and undefined science which many are still exploring and it isn't some highly unknown secret conspiracy that you were the first to uncover - Perhaps some research on the net might help you to realize that you are not alone in your theories."
Jihadista On July 04, 2014

Deleted



Orange,
#3New Post! Dec 06, 2013 @ 13:14:33
@Electric_Banana Said

Autism = Care Provider coverage. The person can't manage on their own.

And I believe that not only including mental health coverage (something that has been majorly needed for years now) ($300 a month for Risperdone - Trust me they're not dodging the meds because they believe they're mind-wipe drugs to shut them up ) I also don't believe that coverage will be in use for very long - It only takes the right person to offer advice in a manner comprehensive to the patient where something clicks and that patient proceeds to mend themselves (I'm talking about schizophrenia and depression whose cure relies heavily on the individual's cognitive practices. ).

First I had a counselor tell me and then a psychiatrist many years later.

They both said the same thing but the second time made sense.

"Congratulations you are now on the same page as the rest of us but your new perception of reality is not an issue unless it causes you grief or results in irrational decision making )."

Most people just need to find others who are completely aware of what they are on about and then help offer different perspectives such as "Left in the dark" can be seen as "Provided an advanced challenge."

Or "Well, no - if you suspect others can sometimes overhear your thoughts that isn't delusional but it is still and undefined science which many are still exploring and it isn't some highly unknown secret conspiracy that you were the first to uncover - Perhaps some research on the net might help you to realize that you are not alone in your theories."


Wow, suddenly I get the picture.

And of course, I should have thought of it, some people with autism might need a care provider.

You must mean Risperidone, which according to Wikipedia, "is used for the treatment of schizophrenia, bipolar disorder, and behavior problems in people with autism."

All of my brothers have had autistic friends. One of them graduated from college, and two more are juniors in college, so like you said, it is possible for people with autism to get on the "same page." And I have a friend who deals with autism. I don't know if any of them take any kind of medication for their autism.
paramour On July 30, 2014




Purgatory Beach,
#4New Post! Dec 06, 2013 @ 19:38:46
I relocated to a state that has parity laws. I would not be surprised if federal laws have the same effect.

I see a variety of different policies where mental health coverage is "supposed" to be covered at the same level. There are loopholes. For one, they tend to restrict this to what they consider "serious" diagnoses. If they don't consider your dx to be on par, you're SOL. Then, they (i.e., the insurance and/or your employer) screw you over by making sure that your medical benefits suck donkey balls to begin with and that they were on par with what they would have paid for mental health coverage anyway (PRIOR TO THAT NIFTY PARITY REQUIREMENT) - so you're truly not gaining sh*t.

I acknowledge that there are a few policies out there where this has been an exceptional help for the client. For most, it's the same ole' BS and the same ole' limitations.

Perhaps I will be pleasantly surprised--but I'm doubting it.
paramour On July 30, 2014




Purgatory Beach,
#5New Post! Dec 06, 2013 @ 19:40:17
As far as autism is concerned, many receive ABA--which is often not a covered benefit by insurance.
Jihadista On July 04, 2014

Deleted



Orange,
#6New Post! Dec 07, 2013 @ 00:32:57
ABA ???

Aplied Behavior Analysis - I had not heard the term, ABA, before, but I have a sense that it is what my school does to help autistic students. And probably they do it informally with all of us, not just special education students.

Autism Speaks
Jihadista On July 04, 2014

Deleted



Orange,
#7New Post! Jan 01, 2014 @ 19:59:42
More about autism


Reply to Topic<< Previous Topic | Next Topic >>

1 browsing (0 members - 1 guest)

Quick Reply
Be Respectful of Others

      
Subscribe to topic prefs

Similar Topics
    Forum Topic Last Post Replies Views
New posts   Jokes & Humor
Thu Mar 17, 2011 @ 01:46
4 916
New posts   Mental Health
Sun Sep 27, 2009 @ 14:55
0 708
New posts   Health & Fitness
Thu Sep 17, 2009 @ 15:46
1 411
New posts   Mental Health
Thu Sep 10, 2009 @ 21:41
12 1148
New posts   Mental Health
Fri Sep 26, 2008 @ 02:36
77 3816