On Thursday, leaders from the mental health advocacy community will gather in Boston, MA for the Kennedy Forum, a conference established to advance the national conversation around mental health care and advocate for policies that will improve our nation’s mental health care system. Panels and conversations at the conference will focus on creating new avenues for treatment for those affected by mental illness and other disabilities.
Honoring President John F...
The federal government is in shutdown mode but the health insurance marketplaces are open for business. People with mood disorders and their families have the opportunity to explore the pros and cons of different insurance plans that become effective in January 2014. Mental health care must be covered, but will the different levels of plans pay for the services you need? What will you need to pay for yourself?
Gretchen, who lives with a mental health condition, is hopeful that her new insurance will cover her preferred therapist and psychiatrist...
The government may not be open for business, but the market exchanges and 24 hour phone lines are operating today!
Marking today’s opening of the health exchanges, Care for Your Mind shares information and resources about who has to have insurance, what’s involved in enrollment, and what we know about mental health care coverage.
Millions more will now have access to mental health care
If you’re looking for health insurance, you have some new options! Today the health exchanges are open for business. That’s because today is the first day of the enrollment period for the health exchanges established under the Affordable Care Act (ACA) to enable the purchase of health insurance.
Here we are providing links to information covering the individual mandate, enrollment in a health exchange, and what is currently known about mental health coverage. Do you know how the ACA is changing health care?
Carol McDaidCFYM Note: This is the last in the series by Carol McDaid on your rights with regards to mental health insurance parity laws and expanded coverage under the Affordable Care Act. Tuesday’s post provided an overview of what types of denials to look out for. Today, Ms. McDaid tells readers how to file a grievance for denial of mental health insurance coverage.
When should I file an appeal
Mental Health America compiled this list of questions to help you understand if you should appeal a coverage denial. At first glance, the questions may seem to require a sophisticated understanding of your plan and the law, but you can simplify it this way: If the answer is YES to any of the following questions, the plan is most likely not in compliance with the new laws.
Carol McDaid
Parity Implementation Coalition
Follow these practical steps to win your appeal.
CFYM Note: Last week, Carol McDaid answered the question, “Doesn’t health insurance have to cover mental health care?” She also described steps to make sure you’re getting all the health care benefits you should. This week, Ms. McDaid covers what the mental health parity law means for you when you don’t get the benefits you’re entitled to.
From promise to reality
The fact that we now have two federal laws requiring mental health parity is cause for celebration—both for those of us who spent years advocating for the laws and those of us, me included, who have been denied coverage by our insurance plans.
The Mental Health Parity and Addiction Equity Act was signed into law in 2008. The Affordable Care Act goes into effect January 1, 2014, and will require more plans, including those in the newly created health insurance exchanges, to offer mental health parity. (Read more about the laws in Part 1 of this series.)
The federal laws are on top of state laws that exist in approximately 40 states to protect people from being denied mental health benefits through public and/or private employer-sponsored health insurance. (View a chart of state mental health parity laws from the National Alliance on Mental Illness.)
Carol McDaidCFYM Note: Many people wonder if their health insurance will cover costs for mental health hospitalization, therapy and medication. Read this first post in a series by Carol McDaid that explains your rights concerning equal insurance benefits in relation to physical and mental disorders.
Hint: Our work isn’t over
As a person living in recovery, I know firsthand the struggles people face when seeking mental health and addiction benefits. I understand what it’s like to be sick and in desperate need of treatment, told by my employer I had to go to treatment, but denied care by an insurance company.
As family caregivers and caring friends of people living with mood disorders or other mental health conditions, we want to help our loved ones by
Sometimes people are in a state of mind that prevents them from making sound decisions. There are mental states (e.g., experiencing psychosis) and physical conditions (e.g., effects from a stroke) that can adversely affect a person’s usual good judgment. We agree with DBSA and others that, ideally, a person with a mental health condition will engage family members and friends as partners in wellness and in crisis. There will be a written plan and the legal documents necessary to ensure that care is pursued and provided according to the individual’s wishes as expressed when he or she was well. Mental health practitioners can make sure that families get information about this and should strongly encourage patients to bring a family member to at least the first appointment.
The Reality
In our experience, all too often these conversations and pre-planning have not occurred, and the family member must navigate the complex medical, insurance, and legal systems to get emergency care for their loved one.
Family members are frequently excluded from mental health care decisions, despite being the ones who often have the most pertinent knowledge and the greatest motivation to get someone the care they need to get well.
When an individual with a mental health condition in need of intensive psychiatric care is hospitalized, whether voluntarily or involuntarily, the individual, family, and friends may have mixed reactions. They may feel relief that the individual is safe, but they may also feel emotionally, physically, and potentially financially drained. Yesterday on CFYM, Dr. Sederer shared his expertise in navigating what can be daunting legal and medical legalities on patient psychiatric hospitalization treatment rights. DBSA believes that patient protections are important to ensuring individuals are the lead decision-makers in their own wellness. The best wellness outcomes are achieved when individuals living with mental health conditions and their family and friends are educated and prepared for crisis.
Education is Power
DBSA encourages individuals to become knowledgeable about (1) mental health laws in the states in which they reside; (2) options for treatment centers and outpatient programs other than hospitals; and (3) the rules and regulations regarding admission and release in hospitals and treatment facilities, both for voluntary and involuntary entry.
Whether hospitalized voluntarily or involuntarily, individuals have the following rights:
DBSA supports adherence to these patient rights in all circumstances.
You Care, Help Share During Mental Health Awareness Month Families for Depression Awareness
For Mental Health Awareness Month, Families for Depression Awareness has launched #YouCareHelpShare, a campaign to provide education and encouragement to family caregivers. Through the distribution of caregiver education materials and a social media awareness campaign, we aim to help caregivers all across the U.S. get the support, information, and resources they need to be effective partners in care.
The importance of caregivers
Caregivers of people with depression or bipolar disorder play a crucial role in their loved ones’ lives. Parents, spouses, siblings, and other close connections are pivotal in recognizing a problem, accessing care, and lending sup...
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