Mental health care advocates say patients face challenges in insurance coverage. iStockphoto.com hide caption

Mental health care advocates say patients face challenges in insurance coverage.

By law, many U.S. insurance providers that offer mental health care are required to cover it just as they would cancer or diabetes care. But advocates say achieving this mental health parity can be a challenge. A report released earlier this week by the National Alliance on Mental Illness found that "health insurance plans are falling short in coverage of mental health and substance abuse conditions."

Reporter Jenny Gold of Kaiser Health News tells NPR's Arun Rath that patients are still having trouble getting their care covered. In this interview, she outlines some of the issues confronting both patients and the insurance industry.

Currently, insurers adhering to parity rules is a mixed bag.

Insurance companies used to have a separate deductible or higher copay for mental health or substance abuse visits. That's sort of gone away. For the most part, insurers really have complied. Right now, there really isn't a separate deductible for mental health and there isn't a higher copay, so on that side, you know, they really have complied. But on another sort of subtler and harder-to-pinpoint side, advocates are saying they're really not complying.

Insurance companies, in order to keep down costs, they will do things called "medical necessity" review. Basically, they look at someone's care and ask is it really medically necessary. And advocates say they're applying those sorts of cost-control techniques way more stringently on the mental health side and the substance abuse side than they are on the physical health side. So people are still having trouble getting their care covered.

Insurers say it's complicated to distinguish between physical and mental health

Insurance companies are arguing this is a really hard law to implement. I spoke with Clare Krusing from America's Health Insurance Plans, which is the insurance industry's main trade group, and she says they're really doing their best to make this work:

"The plans have taken tremendous steps since the final rules came out to implement these changes and requirements in a way that is affordable for patients and again this goes back to the fact that we are at a point where health care costs continue to go up."

View post:

When It Comes To Insurance, Mental Health Parity In Name Only?