[WePow]

As another poster already pointed out, the law has changed regarding mental health benifits. The insurance companies can no longer limit us on the number of visits per year!!!! I just found that out for myself today with my HR dept at work. HR even called our insurance provider and confirmed this was the case!!! I wrote T and he was delighted. That tells me that while the law was changed, the insurance companies are in no way anxious to let Ts know!!!

Thank you Universe for finally here in the USA making them remove that nonsense limit!!! If someone had been burned or hurt badly physically, the insurance would pay usually until the person was healed and a doctor released them. FINALLY someone is recognizing that mental health is as much a part of our physical health as anything else is!

If anyone can find links that describe this change in the law, please post them. I am not able to focus enough right now to hunt for it... but I know something has to be on the net about it.

Sadly, as far as I understand it, that only applies to certain conditions (and it may differ by state...my State Dept of Insurance clarified this for me). I was seeing mine twice a week (beginning of the year I had called my ins. comp., and they had said I had "unlimited" visits for the year)...til my insurance company called my therapist for a "case review". They deemed it "not medically necessary" after speaking with my therapist and cut back the number of visits they would cover to once a week. I was going to have to appeal it in order to maybe get another "consideration", which I did not do yet because the insurance company wanted to talk to my therapist again a month from their decision (which will be in a few weeks)...I wanted to save the appeal for if they decided to cut back their coverage even more, like twice a month.

This site is good for info, and my local branch was really nice when I called:

http://www.nami.org/

My State Dept. of Insurance sent me a lot of great info, too.

I think it's called the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, but I think there are a lot of loopholes in it.

[googley]

This only applies to certain policies. It applies to group policies from companies with over fifty employees. It also does not apply to insurance policies that do not include any mental health coverage, and policies where it would increase the cost of the insurance over 1%. This means it does not apply for people working for small businesses, those who have to buy individual policies, and policies that do not cover mental health care in the first place. Hence I don't get coverage because my school only provides us individual policies.

Here is some information:

http://www.cms.hhs.gov/healthinsrefo...hparityact.asp

http://www.dol.gov/ebsa/newsroom/fsmhparity.html

http://www.dol.gov/ebsa/faqs/faq_con...lthparity.html

[WePow]

Thank you both for the feedback. I know insurance can require a case review. But did not know they could go against what the provider said. VERY interesting. I already told T I would pay out of pocket myself to get the help he and I together think we need. Very interesting for sure!

Yes, I was upset about it all...my insurance covered 90 visits last year and now it has actually gotten worse (same ins. company/same job).

I was actually in NTB when my therapist called to tell me what was up...I was crying all over the place. I am sure everyone else in the waiting room was thinking, "PLEASE finish her car first, please." Anyway, I ended up deciding to pay for my 2nd visit a week on my own. I am getting rid of cable and my home phone line...well worth it.

[emilyjeanne]

Hello everyone,

The law only applies to people with group health insurance. Check the laws in your state. NY's Law is called "timothy's law". http://www.timothyslaw.org/

[velcro003]

As others have said, its for group insurer's with more than 50 employees, and they CAN take away mental health benefits. Luckily,mine did not. The only potential problem is that we switched our mental health provider,a nd now they require a case review every five visits. My T said she'd try it out to see how lenient they would be, so we'll see.

[WePow]

Thanks all for the help. I do see for my case it is a state law change.
It is awesome to know of how much hard work many people have put into making sure mental health issues get the same respect as any other medical concern.

I found this link for TN which is what impacted my situation:
http://www.allaboutbipolar.com/2009/...nges-benefits/

[peaches100]

Anybody have Blue Cross/Blue Shield? If so, how have they been regarding number of therapy sessions? I just switched to BC this January.

[perpetuallysad]

According to this breakdownhttp://www.ncsl.org/default.aspx?tabid=14352, my state-Mississippi-only requires coverage of alcoholism related treatment. The law wouldn't help me anyway, my husband's plan (which I only got on this last month) requires that a $1500 deductible be met before they cover one cent of anything, medical or mental health. I could never afford to pay for visits to my pdoc/t if he charged me his regular rate to work up to meeting my deductible. Geeze, my state is so freaking ****ed up about so many things.

[akunia]

I have bcbs and my plan is thru my hubby. He is in a small grp. plan thru his employer so I am only covered for 20 visits max. I am on disability so at least they pay part when my 20 visits are up but I still have to pay 2x what my copay normally is. It doesn't seem fair to us in the small group plans.

[perpetuallysad]

Peaches, I have BC of Mississippi. They cover visits, after the deductible is met. There is an 80/20 copay.

Also, I misread the chart. They are required to pay for mental health services in MS as long as it doesn't cost 1% increase or more. And the law only requires that insurance pay 50% of the cost of outpatient treatment.

[emilyjeanne]

Originally Posted by wpowers

Thanks all for the help. I do see for my case it is a state law change.
It is awesome to know of how much hard work many people have put into making sure mental health issues get the same respect as any other medical concern.

I found this link for TN which is what impacted my situation:
http://www.allaboutbipolar.com/2009/...nges-benefits/

Unfortunately, changes are not made until there has been a death. That is what happened with "timothy's law in NY". It is almost like the airline industry. They don't make changes until there is a crash.