The Daily Item, Sunbury, PA

Business

September 23, 2013

The Color of Money: The ACA and mental health care

(Continued)

     But starting next year, this will change for many workers.

     Under the Affordable Care Act, insurance plans offered in the new marketplaces will have to cover a core set of services called "essential health benefits." Included on the list of 10 benefits are mental health and substance-use disorder services, which include behavioral health treatment, counseling and psychotherapy. Specifically, as part of what's considered preventive services, plans will also cover alcohol-misuse screening and counseling, depression screening for adults and for adolescents, domestic and interpersonal violence screening for women, and behavioral assessments for children.

     Here are two important points about mental health coverage under Obamacare. First, the coverage for behavioral health services must be generally comparable to coverage for medical and surgical care. Second, plans offered in the marketplace have to the cover preventive services without charging customers a copayment or coinsurance even if you haven't met your yearly deductible. However, the services have to be delivered by a network provider.

     The Kaiser Family Foundation noted in a report released this month that benefits will be extended in many cases to cover services typically now excluded, such as mental health. Starting next year, health plans won't be able to deny coverage or charge you more because of a pre-existing health condition, including a mental illness.

     Think this issue doesn't affect you? Well, take a look at these statistics from www.mentalhealh.gov:

    -- One in five adults has experienced a mental health issue.

     -- Half of all mental health disorders first show up before a person turns 14. Three-quarters of mental health disorders begin before 24. But less than 20 percent of children and adolescents with mental health problems receive the treatment they need.

     -- One in 20 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder or major depression.

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