The Maze of Health Care Reform

I recently recieved a letter from my insurance carrier indicating that my policy now includes more extensive coverage for psychotherapy due to the Patient Protection and Affordable Care Act and the Health Care and Education Reconcilliation Act. So I set out on a mission to understand what is happening. Wow. Not so easy.

What became clear is that this is a monumentous time in American health care, and we are likely to be in some degree of confusion as we find our way through these changes. It appears that there is good news for mental health/psychotherapy benefits. Over the next months and years, you should see some improvement in your existing mental health benefits.

And if you don’t have insurance, you will find more affordable and regulated options available by January, 2014. All plans need to include coverage for mental health. According to Judge David L. Bazelon, “For plan years that begin after October 1, 2010, insurers are no longer able to establish lifetime limits on essential benefits. This means that insurers will not be able to cap the total amount of dollars that they will pay for essential benefits, such as mental health care, provided throughout the lifetime of an enrollee in the plan.”

To read more of Judge Bazelon’s analysis, go here: HEALTH CARE REFORM

Some insurance carriers have already begun integrating these changes. So if you have mental health benefits and you are currently in or considering psychotherapy, I recommend that you call your insurer and ask the following questions:

Have any of the following things changes in my mental health benefits?

Do I have a limit on the number of sessions per year?
What is my annual out-of-pocket limit?
Does my diagnosis affect the amount of coverage I have?
What is my co-pay structure?

If nothing has changed, check again in January, 2011 when some plans will be implementing new policies. It looks like things will be in flux for awhile!