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Metal Levels – View Psych Benefits – Search and click – namely Out Patient Professional Services

Mental Health
as an essential benefit under Health Care Reform

Every qualified health plan (ObamaCare compliant-meeting the 10 essential benefits) must provide parity coverage for mental health and substance use services resulting in no added treatment limits and no extra costs.

Learn More ⇒  NAMI (National Assoc of Mental Illness) Website, Insurance & Health Care Reform Section

More than 43 million Americans suffer from depression, anxiety, and other mental health conditions, according to the most recent federal data. But more than half the people who felt like they needed help last year, never got it. Even people who had insurance complained of barriers to care.  Narrow Provider Lists?  Some said they still couldn’t afford it; some were embarrassed to ask for help. Others just couldn’t get through the red tape.

Learn More ==>   KQED: Single Mom’s Search For Therapist Foiled By Insurance Companies  (Dembosky, 5/22)

Dealing with social & mental problems can cut health care costs CA Health Line 1.23.2017

Information, links and resources

May is Mental Health Awareness Month

Medicare & Mental Health Benefits # 10184

Mental Health Parity Act 1996 Wikipedia

Health Net 2014 Employer Group Manual Page 87

Parity – Using Employer Sponsored Plan SAMHSA 8 page pdf

Be sure to, to verify the actual benefits for mental health according to metal level and each companies brochures and eoc – evidence of coverage.

Individual – Specimen Platimum EOC – Evidence of Coverage –  search for “mental”

Pervasive Developmental Disorder or Autism

More detail

Substance Abuse – Chemical Dependency

More detail

Emergency Definition   §5150 Welfare & Institutions Code – Wikipedia

More

Outpatient Facility

Skilled Nursing Facility

Educational Services

Severe Mental Illness and Serious Emotional Disturbance of a Child  – AB 88

More

Mental & Nervous Disorders

Residential Treatment Center

Severe Mental Illness

Medical Necessity

Clinical UM – Utilization Management Bulletins

Behavioral Health
CG-BEH-08 Employee Assistance Program Outpatient Treatment
CG-BEH-10 Basic Skills Training/Social Skills Training

Sacramento Bee 2.4.2014 reports increase in youth hospitalizations.

Jail not the place for the mentally ill aclu socal.org

Technical Links & Resources

42  USC  18022 (E) Mental health and substance use disorder services, including behavioral health treatment.

CFR 156.115 (a) (3), – Provisions of Essential Health Benefits

Federal Mental Health Parity

2008 Final Rules

§146.136   Parity in mental health and substance use disorder benefits.

Related & Child Pages in 10 Essential Benefits  Section

Please use the menu system at the top.

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