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Coverage Limits for Mental Health

From the Show: Health Radio
Summary: What are the insurance coverage limits for mental health, behavioral health, and substance use disorder?
Air Date: 3/17/16
Duration: 10
Host: Melanie Cole, MS
Guest Bio: Marianne Eterno, President of Government Relations for GTL
Marianne Eterno Marianne Eterno began her insurance career in 1987 at the former Golden Rule Insurance Company in Indianapolis, Indiana, and moved to Chicago in 1992, when she accepted a position with Celtic Insurance Company.

Marianne came to Guarantee Trust Life Insurance Company (GTL) in 1996, as a compliance and government relations consultant, and formally joined the company in 1997. As Assistant Vice President of Government Relations, she represents GTL in both the state and federal arenas, drives coalition development for the company, and serves as the company's media and public relations spokesperson.

In addition to sitting on committees for every major insurance trade association, Marianne serves on the Board of Directors of RetireSafe, a 400,000 member grassroots advocacy organization for senior citizens and as the Executive Director for the Council for Affordable Health Insurance.
Coverage Limits for Mental Health
In 2008, a law was passed that health insurance plans that include mental health, behavioral health, and substance use disorder coverage must treat those services comparable to physical health services.

This doesn't mean that every plan will cover mental health. It means that every plan that has mental health coverage must treat it the same as it does physical health coverage.

Check your plan coverage to see if you have mental health benefits. Your specific benefits will vary by state, provider and plan. If you seek mental health, behavioral health or substance use disorder services, keep this in mind when comparing plans.

If you have mental health coverage, benefits start the day your plan starts. Pre-existing conditions are covered and spending limits are not allowed.

While mental health parity exists, you should know there are limits on par with physical health services:

  • Financial. There are co-pays, deductibles, co-insurance, and out-of-pocket limits.
  • Treatment. There may be a limited number of days or visits covered.
  • Care management. Pre-authorization for services may be required before obtaining treatment.
For more information on mental health support, visit http://www.mentalhealthamerica.net/.

Health insurance expert and President of Government Relations for GTL, Marianne Eterno, joins host Melanie Cole to discuss what you need to know about mental health coverage.
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