Is medical expense coverage available for substance abuse and mental illness?
Major medical expense plans also generally provide coverage for treatment of substance abuse (e.g., alcoholism and drug usage) and mental illness. A higher coinsurance percentage (e.g., 50 percent) and a lower lifetime benefit limit (e.g., $25,000 or $50,000) generally applies, however. In addition, the extent of coverage may depend on whether treatment is provided on an in-patient or out-patient basis.
Major medical expense plans also generally provide coverage for treatment of substance abuse (e.g., alcoholism and drug usage) and mental illness. A higher coinsurance percentage (e.g., 50 percent) and a lower lifetime benefit limit (e.g., $25,000 or $50,000) generally applies, however. In addition, the extent of coverage may depend on whether treatment is provided on an inpatient or outpatient basis.
Yes. Coverage varies from state to state. In Connecticut, coverage for groups of 1 to 50 lives is mandated for mental illness and substance abuse. On an inpatient basis mental illness must be treated the same as any other illness for 60 days per member per calendar year. On an out patient basis mental illness must be covered at a level of 50% of the maximum allowable amount up to $2,000 per person per calendar year. Expenses incurred in connection with behavioral health problems which are biologically based are not subject to the sixty day calendar year limitation. Substance abuse must be covered subject to a member co-payment of no more than $200 per admission for inpatient services for at least 45 days per calendar year. Coverage may be more liberal than state mandated levels. Individual health insurance carriers are not constrained by mandates and many limit coverage for mental illness and or substance abuse to a specific lifetime maximum of $10,000 or similar amount.
Major medical expense plans also generally provide coverage for treatment of substance abuse (e.g., alcoholism and drug usage) and mental illness. A higher coinsurance percentage (usually 50 percent) and a lower lifetime benefit limit (usually $25,000 or $50,000) generally applies, however. In addition, the extent of coverage may depend on whether treatment is provided on an in-patient or out-patient basis.
