For people who depend on any type of private or company insurance to cover the cost of their health needs, the question of whether or not the health insurance policy covers mental health problems is a crucial one for a number of reasons.
The idea of a split between physical health and mental health is an old one, and is a fairly arbitrary decision as to which is which some of the time. From a point of view of health insurance, classifying illnesses or diseases can determine whether or not the insurance company will pay for them, and for many people with mental health issues that can literally be a life or death process.
The term mental health can relate to a condition ranging from a fairly mild form of depression through to serious conditions of clinical depression, schizophrenia, alcoholism, full-blown psychotic episodes etc.
Any health insurance policy should specify exactly what types of illness or disease it is willing to provide cover for and those which it is not. This will also include what it specifies as a type of mental health problem or issue and whether or not the insurance policy provides any type of cover for it.
One of the reasons people are wary of health insurance plans with relation to mental health issues, is that often any type of treatment for a mental health issue relates either to what is known as a talking therapy, or some type of pharmaceutical drug based regime.
Any type of talking therapy that is likely to be effective is likely to be a relatively long-term process, depending upon the nature and seriousness of the illness. Any insurance policy that does cover specified mental health conditions will also provide very strict criteria as to what type of talking therapy is covered, for how long and by whom the talking therapy can be carried out by.
The other issue to be really aware of when looking at any type of mental health coverage under a health insurance plan is the nature of deductibles, co-pay and co-insurance. These terms are essentially ways of getting the person who is insured under the policy to bear some of the cost of the treatment on an ongoing basis in relation to the insurance company.
Most people are familiar with the idea of a deductible, sometimes called an excess, in a policy, but any health insurance policy needs to be looked at carefully in terms of what it’s deductibles are. This is because there are often several different deductibles applicable to the same policy, each for differing amounts and applying to different sections of the policy.
This means that a health insurance policy could have both an individual and a family deductible. This deductible could be separate from another deductible that would apply to specific types of drugs, normally where a distinction is made between a generic and a brand-name drug. The amounts involved in terms of these deductibles can be significant, and when taken in addition to any co-pay or co-insurance amounts can stack up into a sizeable burden that the individual will have to carry for themselves.
In summary, as with any insurance policy, it is important before taking out the policy to have complete clarity about what is and is not covered, as the level of coverage and the specifics of what is and is not covered will vary widely between health insurance policies.
Peter Main is freelance writer who writes extensively about health, healthcare and health insurance with a particular focus on current issues and debates, such as the state of healthcare reform and how it impacts on peoples lives.
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