Mental Illness and Health Insurance

mental illness and health insurance text overlaying image of flowers falling out of a cutout of a head In the last few years mental illness has steadily become a topic of conversation for many people. We’re seeing people take their mental health more seriously. It’s important to take care of your mental health. In fact, it’s just as important as your physical health. Insurers haven’t always seen it this way, though. In the past, many health insurance companies covered physical health problems greater than mental health problems. However, thanks to the Mental Health Parity Act and the Affordable Care Act, health insurance covers mental health the same way it covers physical health. Below we’ll look at both of these laws and why mental health is so important.

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Mental Health Parity Law

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Act was passed in 2008. The law is more commonly known as the mental health parity law or the federal parity law. It says that insurance companies must treat coverage for mental illness and behavioral health and substance use disorders the same as coverage for medical and surgical care. This includes treating them the same financially. For example, an insurance company can’t charge a $40 copay for an office visit to a mental health professional when they only charge a $20 copay for most medical office visits. 

 

The parity law also covers limits on treatment that are not related to money. For example, it used to be common to put limits on the number of visits to mental health care that could be made in a year. The law has pretty much done away with these annual limits, but it doesn’t stop the insurance company from putting limits in place that have to do with “medical necessity.”

Health Plans Affected By The Mental Health Parity Law

In general, the following types of health insurance are covered by the mental health parity law:

 

  • Employer group health coverage for companies with more than 50 employees
  • Plans bought through a health insurance exchange 
  • Children’s Health Insurance Program (CHIP)
  • Most Medicaid programs, however requirements can vary from one program to another

Some other plans and programs run by the government are still not covered by the parity law. The federal parity law does not apply to Medicare, but it does apply to Medicaid. Some state employee plans, like those that cover teachers and people who work at state universities, can choose not to follow the parity rules.

Diagnoses Covered By The Mental Health Parity Law

The federal parity law covers all mental health and substance-use disorders that a health plan covers. But a health plan can choose to not cover certain diagnoses, whether they are in the physical/medical realm or the behavioral/mental health realm. This is because the parity law doesn’t require insurers to offer mental health benefits. Instead, it says that if mental health benefits are offered, they can’t have stricter requirements than physical health benefits. Your plan’s description of mental health benefits should tell you about any exceptions.

Mental Health And The Affordable Care Act

The Affordable Care Act (ACA) was passed in 2010, and its goal was to make healthcare more affordable. Plans that follow the ACA guidelines include mental health care as one of the “10 essential health benefits”. This means that if you sign up for an ACA-compliant health plan, your mental health services are covered. The ACA also says that insurance companies have to put a limit on how much customers have to pay out of pocket and that there can’t be limits on how much mental health care is covered annually or for a person’s whole life. These steps make sure that people can get mental health insurance and that it is affordable.

What Mental Health Services Are Covered?

All ACA compliant plans should cover mental health as an essential health benefit. Your plan should cover some or most of the cost of mental health services, just like it would for other medical conditions. All plans under the ACA must cover the following mental illness services:

 

  • Outpatient individual or group counseling and therapy
  • Diagnostic services like psychological testing and evaluation
  • Ongoing outpatient treatment such as treatment programs and medication management
  • Outpatient treatment for alcohol or chemical addictions
  • Detox services
  • Substance abuse recovery treatment
  • Inpatient mental healthcare in a psychiatric facility

Why Mental Health Coverage Is So Important

There are many reasons why having health insurance that covers mental health needs is a good idea. Mental health issues can happen to almost anyone at any time, with most of these issues needing treatment. The cost of therapy and medication can quickly add up and get expensive. If you don’t have insurance for mental health, you would end up paying out-of-pocket for your care. It could easily amount to tens of thousands of dollars. On top of being financially beneficial, mental health coverage can also save lives. If you have a mental health condition, it’s hard to put a price on how important treatment is. Let’s look further into the impact mental health has.

  • Physical Health

Studies show a link between mental health and physical health. Mental illness can cause stress and make our immune systems less effective. Because of this, our bodies may not be able to handle illness as well. When your mind is sick, you might develop anxiety or depression, which can make it difficult if not impossible to stay active. Which can lead to letting your physical health deteriorate and struggle to correct it.

  • Relationships

One of the most interesting reasons why mental health is so important is that it affects your personal relationships. Mental illness can change the way you talk to your friends and family. People with mental illness are often passive-aggressive, hostile, and unable to join social activities. This can cause problems within your emotional support system. Mental illness can make us want to hurt people we care about for no apparent reason. Taking care of our mental health on our own and, if needed, taking medicine can help us live a mentally stable life and keep our relationships.

  • Emotional Well-Being

How you feel on the inside every day is just as important as how healthy your body is. Advice about mental health shows how a negative mind can make you feel sad, angry, or uneasy. Taking care of your emotional health can help you be more productive and effective at work and in your daily life. You can get advice about your mental health from friends, family, and a psychologist to keep an eye on your emotional and overall health.

  • Prevent Suicide

A study by the National Alliance on Mental Health (NAMI) found that 46% of people who kill themselves have a known mental health problem. In another study, the US Department of Health and Human Services found that about 60% of people who killed themselves had a mental illness like major depression, bipolar disorder, or dysthymia. This shows the link between mental health and suicide, as well as how early medical intervention and self-care can help reduce the number of suicide deaths. It is important to follow advice to keep our mental health in good shape and to always be aware of the mental health of those around us If you or someone you care about is in trouble, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). This number is toll-free. Anyone can use this service 24 hours a day, 7 days a week.

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  • Prevents Criminal Behaviors

Some studies show that if you have a mental health condition, you are more likely to commit violent crimes. The risk is even higher if you use drugs and alcohol and refuse to get proper treatment. Mental health conditions are often the cause of someone committing crimes against their family or friends.

  • Financial Stability

One of the many reasons it’s important to take care of your mental health is that it makes you more productive and financially secure. According to research published in the American Journal of Psychiatry, people with serious mental conditions earn 40% less than people without. The World Health Organization also says that depression alone causes nearly 200 million lost workdays every year. It is well known that people with poor mental health are less productive, which hurts their finances. It is important to take care of mental health in the right way if we want good work performance and financial security.

EZ Can Help

Getting help for any signs of mental illness shouldn’t be hard because of how much it costs. We can help if you think you can’t get help because you don’t have enough insurance or can’t afford health insurance. You don’t have to worry about paying for EZ’s help to find an affordable health insurance plan because it is free. We want to make sure that you get the help you need. We’ll give you your own agent, who will compare all the plans available in your area and give you quotes in minutes. We won’t just help you find the best plan, we’ll also sign you up for free. Enter your zip code in the bar below to get free instant quotes, or call 877-670-3557 to talk to a live agent.

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Why Are Senior Suicide Rates Rising?

Suicide is often associated with young people, but it is in fact much more common among seniors. The suicide risk increases with age, and is unfortunately hard to estimate the exact number due to “silent suicides.” Silent suicides are considered those of overdose, self-starvation, and self-dehydration. 

Woman with gray hair sitting on a bench looking out into the dessert.
Loneliness is a large problem for seniors and puts them at a higher risk.

Seniors at long-term care facilities are taking their lives more than ever. Some can no longer accept the fact that they are slowly dying, while others have mental health issues. Most mental health issues do not get addressed for the elderly. Why? Either they do not speak up about it, or it is not covered by insurance. So, why is the suicide rate going up?

Loneliness & Depression

Losing a loved one and feeling alone contributes greatly to a person committing suicide. Extensive research shows that post-breakup or losing a spouse, elderly men are at a high risk of suicide. Loneliness is a large problem for seniors and puts them at a higher risk. They feel like they have no one to talk to and fall into depression. 

Mental Health

The National Alliance on Mental Illness estimates that about 1 in 5 adults deal with some form of mental illness each year. About 20% of adults sixty-five and older in America are diagnosed with either schizophrenia, bipolar disorder, depression, anxiety disorders such as OCD (obsessive-compulsive disorder), and/or certain phobias. Some seniors will not seek help, get it too late, or get misdiagnosed. 

Substance Abuse

Once a senior has dealt with a life crisis such as the loss of their spouse, or falling into depression, they can turn to alcohol and drugs. This is the third most common risk factor of suicide in seniors. Substance abuse has been an issue for years, but  recent rates show significant rises. The government is struggling to reduce the opioid issue in America, especially among seniors.

Physical Health

Physical ailments are hard to accept, Learning you can no longer function, or move around the same way, takes a toll on a person’s mental state. A research conducted in 2017 found that seniors with traumatic brain injury, sleep disorders, and HIV or AIDS had an increased suicide risk. Some seniors feel like they are better off gone than to need constant care. This is also a large reason as to why seniors in long-term care facilities will take their own life. Instead of waiting for death, they choose to meet it.

Finances

calculator balancinf a spoon with coins in it and a potato stuck on the other end.
Many seniors struggle to pay their medical bills, housing costs, and daily living expenses, so they look for a way out with suicide.

The National Council on Aging (NCOA) has found that more than 25 million Americans sixty years old and older are living at or below the federal poverty level. Many seniors struggle to pay their medical bills, housing costs, and daily living expenses. This stress leaves them feeling hopeless and considering suicide. That way they will no longer have to deal with the burden and will not have to put pressure on their family. 

There is always an easier way to deal with stress. Seek help and talk to a professional if you feel suicidal. Reach out to your family, and know that you have a sense of purpose. If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line.