HEALTH INSURANCE PROGRAMS

Many people cannot afford treatment for depression because the either lack health insurance or their insurance does not adequately cover the costs. Coverage varies, and there is no definitive answer to the benefits health maintenance organizations and employer based group health plans provide, according to the American Association of Health Plans.

As most holders of health insurance know, insurance is a contract between two entities, usually an insurance company and an employer. The level of benefits agreed upon by the two parities is the amount paid when a claim is made. Some states mandate minimum or maximum benefit levels for group contracts in their state, usually a specified number of visits or inpatient days per person, year of lifetime. State laws vary considerably.

A person purchasing individual insurance may or may not be offered mental health cover-age, depending on the insurance company contacted and the person’s medical history. The coverage offered will probably have the same deductible/co-payment as the physical health coverage but may have some inside limits on annual or lifetime maximum payments for mental health services.

In 1996 the Mental Health Parity Act was signed into law, but loopholes in coverage exist. According to the Health Care financing Administration, group health plans are not required to include mental health coverage in their benefit packages and at this writing, can set terms and conditions relating to the amount, duration or scope of mental health benefits.

Some states and members of Congress have made efforts to eliminate the disparities is insurance coverage of mental disorders by fighting for equal rights for health insurance coverage of mental ailments, and Congress has been considering legislation that would bar health insures from paying less for mental disorders than for physical disorders.

This is a step in the right direction because as Dr. David Satcher pointed out in Mental Health : A report of the surgeon General equality between mental health coverage and that for other illness is an affordable and effective objective. The Surgeon General’s report stated that when mental health care is properly coordinated by an HMO or a firm specializing in such care, parity causes negligible cost increases.

Medicare pays for a variety of mental health care services, but people must meet certain conditions to qualify.