Mental Illness Insurance Coverage Is A Must For Modern Employers

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The prevalence of depression and anxiety in adults has skyrocketed since the start of the covid-19 pandemic, according to the most recent study by Mental health America. Mental illness can affect anyone, regardless of their history, age, status, function or other personal factors. Whether you know it or not, you have employees who are currently experiencing mental health issues.

As an employer, you want to create an environment that allows employees to do their best and feel good about their contributions. Part of creating this positive work environment should involve providing employees with the health coverage they need to address any mental health or substance use issues they encounter.

Open enrollment is just around the corner, so now is a great time to take a closer look at the health insurance coverage you offer to employees and make sure it includes appropriate mental health coverage.

Are mental health services covered by health insurance?

Most health insurance plans cover mental health and behavioral health services, but it’s never a bad idea to check the details of the coverage.

The Mental Health Parity and Addiction Equity Act 2008 was passed to push insurers to treat mental health treatment the same as treatment for physical health problems. It requires insurance companies to avoid placing additional limitations on mental health or addiction services that are less favorable than limitations on other health services. For example, an insurer can no longer limit the number of counseling sessions covered, if the sessions for other health problems are not limited. Co-payments for mental health services should also be similar to co-payments for other specialized services, including inpatient services.

All health plans offered on the government market, which can be viewed at health care.gov, cover mental health services as an essential health benefit under the Affordable Care Act (ACA). The ACA also prevents insurance companies from denying coverage for pre-existing conditions and requires that they cover preventative services. Most employer sponsored health plans are ACA compliant and will cover mental health treatments.

However, there may be other barriers to accessing mental health care through employer-sponsored insurance plans, such as:

  • Long waiting times for admission appointments.

  • A lack of networked providers in the employee’s area.

  • Not being able to take time off work for appointments.

  • High co-payments by appointment.

  • High deductibles making hospitalization or hospital care inaccessible.

Take a look at the group plans you plan to offer as well as any other drug plans to make sure cost won’t be a barrier to accessing care. It can also be helpful to train managers and human resources staff to be flexible about time off and to be sensitive to those who need time off to access mental health or substance use disorder services. .

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Why is it important to provide access to mental health coverage?

After a hectic year and a half with frequent changes in work and life due to the pandemic, employees are more exposed than ever to burnout or other mental health issues.

Employees who have mental health issues are likely to be less focused and less engaged with their work and their peers. This can lead to a decrease in their performance at work. As a business owner or manager, you want your employees to be able to meet the expectations of productivity, quality of work and customer service. Most employees want to meet these expectations as well, but sometimes they need extra help to make sure they’re in the right space to meet their work and personal obligations. This is where psychotherapy, medication, outpatient services and other mental health treatments come in.

Disgruntled employees can also negatively impact the overall culture of your business. When a small group of employees are unhappy, it can spread and cause other employees to disengage. Of course, mental illness is not contagious like the flu, but untreated illnesses like depression or anxiety can lead to lack of commitment or negative feelings about the business. Showing that you care about your staff through your benefit offerings also fosters a positive culture. Investing in better health insurance with mental health coverage for your employees is an investment in your people and your organizational culture.

This is important from a business point of view, but also from a human point of view. Accessing mental health care can be difficult due to the stigma associated with mental illness and addiction, so do your best to avoid letting insurance coverage become another barrier to treatment for your employees.

How can you make sure employees have access to mental health care?

You want your employees to have easy access to care. When evaluating care, here are some considerations to keep in mind.

Review health care coverage documents

Take a look at the health plans you currently offer. Are mental health services covered by everyone? Are there enough networked behavioral health care providers covered by the plans in your area? Do you have at least one plan with a reasonably affordable co-payment?

Many employers offer plans with low monthly premiums but high deductibles and co-payments, which is ideal for employees who do not use healthcare services frequently. However, employees who seek services such as weekly therapy sessions, regular visits to a psychiatrist, and ongoing medication tend to be better served by plans with lower co-payments and slightly higher premiums. You want to give employees plans they can actually afford to use. Pay close attention to deductibles, inpatient treatment fees, and copayments for appointments for mental health services.

HMO vs PPO

When it comes to deciding between HMO and PPO plans, there is no correct overall answer on which is better for the insured, as both have pros and cons. If your business operates in an area where HMO health systems are popular, you will likely have employees who would like the option to enroll in an HMO. You should try to avoid offering an HMO as the only option.

Ideally, employees will be able to choose from multiple insurance plans and providers to select a plan that best meets their needs. However, small businesses often begin to offer only one option. If you have to stick with just one insurance plan or provider, choose a PPO. PPO insurance provides more flexibility in choosing health care providers, and referrals are generally not required to see mental health care providers. This is important for those looking to receive mental health services, as mental health treatment is most effective when the patient is able to find a therapist, psychiatrist and / or facility with which they feel they are at home. easy. Some large HMO health systems have come under intense scrutiny in recent years for the quality of their mental health services, and this is to be expected as one system and their set of treatment practices cannot respond. to the unique needs of each in such a personal and complex field. like mental health.

Employee assistance plans

Employee Assistance Plans (EAPs) are increasingly popular as a way to provide assistance to employees, including support for mental health treatment and addiction recovery. EAPs help employees access professional support for mental health support, addiction recovery, legal aid, and directories to find child and senior care services. EAPs often cover a limited number of free counseling sessions for employees. These plans are a great way to provide additional support, but are not a substitute for proper mental health coverage in your employer sponsored health insurance plans.

Encourage the mental well-being of employees

Providing adequate mental health insurance coverage is one of the most important steps you can take as an employer to promote employee well-being in your workplace. Employees who need support should be encouraged to seek care from mental health professionals, and you should provide a workplace that is also welcoming and supportive. Providing flexible time and time off options, EAPs, and a culture of open communication can also help employees access mental health care.

Also be aware of employee burnout and stress to support employees during this time of heightened anxiety. Make sure everyone is taking breaks, using their time off balances, and not working excessive overtime. Communicate with employees during busy seasons or times of change (including the transition to the office!) To promote workplace well-being and mental health.


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