Social Security/Medicare

SOCIAL SECURITY, MEDICAID, MEDICARE
There are Federal and State Assistance Programs, if you can just figure out how to get them.  We’ll start you down the path with this summary of information.

 

We will be happy to email  you detailed information on how to apply.
Please contact NAMI-WRV at 309-1987   or email NAMI-WRV at info@nami-wrv.com

 

MENTAL HEALTH PARITY ACT – EFFECTIVE JULY 1, 2010
 
The following is a brief explanation of what the new law requires taken from the U.S. Department of Health and Human Services website (www.HHS.gov)
 
“The issue of [Mental Health Insurance benefits] parity dates back over 40 years to President John F. Kennedy, and was also supported by President Clinton and the late Senator Edward Kennedy.
 
The Wellstone-Domenici Act is named for two dominant figures in the quest for equal treatment of benefits.   The late Senator Paul Wellstone (D-MN), who was a vocal advocate for parity throughout his Senate career, sponsored the ultimately successful full parity act.  He was joined by former Senator Pete Domenici (R-NM) who first introduced legislation to require parity in 1992.  Champions of the legislation also included the bipartisan team of Representative Patrick Kennedy (D-RI) and former Representative Jim Ramstad (R-MN).”
 
The new law requires that any group health plan that includes mental health and substance use disorder benefits along with standard medical and surgical coverage must treat them equally in terms of out-of-pocket costs, benefit limits and practices such as prior authorization and utilization review.  These practices must be based on the same level of scientific evidence used by the insurer for medical and surgical benefits.  For example, a plan may not apply separate deductibles for treatment related to mental health or substance use disorders and medical or surgical benefits—they must be calculated as one limit. MHPAEA applies to employers with 50 or more workers whose group health plan chooses to offer mental health or substance use disorder benefits. The new rules are effective for plan years beginning on or after July 1, 2010.

During the18 years that it took to pass this legislation, health insurance companies  typically restricted mental health benefits to low lifetime maximums ($10,000), high out-of-pocket costs (50%), and very limited coverage for doctors’ services ($500 annually). The lifetime benefit was so low that it could be used up in one hospitalization.
 
Due to NAMI National’s tireless work, quite a few states passed legislation on mental health parity; however, this resulted in a hodge-podge of regulations that varied widely from state to state.
 
 Finally we have Federal regulation that if an employer with 50 or more employees, chooses to include mental health/substance use benefits, those benefits must be on-par with  all other health care coverage.
 
 Of course many people with mental illness are unable to work full time, and won’t be covered by a group plan; and undoubtedly many employers will choose not to include mental health benefits; nonetheless, this legislation is a step forward and surely many more people will have this important coverage.