In the relationship between managed care and mental health,k not all plans offer the same type and level of coverage for this type of service. Long-term mental health services may not be covered under a health insurance plan, and some insurance policies do not pay for any mental health services. Consumers who want a managed care plan which will pay for these types of expenses may need to do some leg work to confirm that mental health costs are covered before deciding to apply for coverage.
In the United States, health insurance consumers can choose from different companies offering managed care and mental health treatment. Each one determines what types of services it will cover and to what extent. The level of the annual deductible and co-payments required varies from plan to plan. Companies providing can be very conservative about what types of health care expenses they are prepared to fund, and this concept extends to managed care and mental health services.
In some cases, mental health services offered under a managed care plan are treated separately from other types of covered services. The company may have separate deductibles or maximum levels of coverage for mental health services. Since the idea of putting health insurance coverage in place is to shield the policyholder from having to pay for these expenses personally, having separate policy terms for these services may make seeking help for mental health issues something which is financially out of reach for sufferers
A person who is interested in looking at options in managed care and mental health services should make a point of investigating different plans carefully. Some plans will only cover acute care services, which would benefit someone who requires help on an urgent basis, but will not fund ongoing treatment at a doctor’s office or a treatment facility. The consumer will also need to consider how much he or she can afford for health care coverage before making a choice.
An issue which comes up around managed care and mental health services is that some companies compensate providers based on a case rate instead of fees for services provided. The plan member is not made aware of how much the insurance provider is paying for the care being given. The managed care company wants to be able to control its costs and putting restrictions on the amount of care given to people seeking treatment for mental illnesses is a way for it to achieve this goal.