If you have private health insurance, you should be aware of mental health parity. Parity requires health insurance plans to cover treatment for mental health and substance use disorders in the same way as treatment for other health conditions. There is a federal mental health parity law, the regulations are in effect, as well as a Minnesota law that has been in place for a number of years. Unfortunately, these laws typically do not apply to health insurance offered to individuals and through small employers (under 50 employees individual policies except through MNsure), or Medicare or Medicaid. Parity laws do not require a health insurance plan to cover mental health and substance use treatment but do require plans that cover these treatments to cover them in the same way as other health conditions. If a plan has to follow the parity law, it must treat mental health and substance use disorders in the same way as other conditions in three main areas:
In order to file a mental health parity complaint through the Department of Commerce, you can fill out an online form at https://mn.gov/ commerce/consumers/file-a-complaint/. Using this form, you should register a complaint on Life/Health Insurance and then specify the specific issue that you are having. If you are having trouble navigating the Department of Commerce website, you can also call their Consumer Services Center at 651-539-1600. If you are an individual or small group HMO policy enrollee, then you should contact the Department of Health at 651-201-5100 or 1-800-657-3916. Federal parity also applies to the criteria used by health insurers to approve or deny mental health or substance use treatment. The standard for “medical necessity determinations”—whether the treatment or supplies are considered by the health plan to be reasonable, necessary, and/or appropriate—must be made available to any current or potential health plan member upon request. The reason for denials of coverage must also be made available upon request. Under state law, the Department of Commerce now has the authority to request information from the health plans to determine whether the plans are using NQTLs more restrictively to limit mental health and substance use disorder benefits. Federal law bars health plans that offer mental health benefits from setting annual or lifetime limits differently than limits for other medical benefits. Under Minnesota law, health plans licensed by the state cannot have higher co-payments or different limits for mental health or chemical dependency services than other medical services. Here are some signs your health insurance plan may be violating parity laws:
If your health plans denies coverage for your mental health or substance use disorder treatment, you can appeal it and ask for more information about why your treatment was denied. Should your health plan deny coverage upon review and you believe this violates mental health parity, then you should contact the Minnesota Department of Commerce at 651-539-1600, MN Department of Health or the US Department of Labor at 1-866-487-2365. To learn more about parity laws, visit www.nami.org/parity, paritytrack.org or parityispersonal.org. Those websites will also have resources for filing a complaint if you have a self-insured plan through your employer that may not be following parity laws. Please call NAMI Minnesota as well at 651-645-2948. Author: NAMI MinnesotaThis content was taken from NAMI Minnesota's Hope for Recovery booklet. View more of their publications, here. 1. Introduce yourself. Describe who you are and why you are speaking or writing. Knowing your name and where you live helps legislators remember you and feel connected. Complete the following sentence or write your own: I’m (name) and I’m from (county or city). 2. Let your legislator or committee members know what you are advocating for. If possible, name a specific bill. Complete the following sentence or write your own: I’m (writing or here today) to ask for your support to build our mental health system. 3. Let your legislator or committee members know how you are impacted by mental illnesses. This gives a real face to mental illnesses and recovery. Complete the following sentence or write your own: I (live with or am a parent of a child or have a relative/friend with) a mental illness. 4. Tell your story. To tell your story effectively, answer the following questions in a few sentences:
Complete the following sentence or write your own: Before I/we got the help I/we needed, I/we went through some challenging times such as...
Complete the following sentence or write your own: The support I get from my (name of service or type of professional) has helped me manage my (main diagnosis or mental health condition).
Complete one of the following sentences or write your own. Today, I am (a peer-support specialist; working part time; living on my own; doing much better; hopeful, staying out of jail/hospital, etc.). 5. Make your point. Help others by giving a brief positive message about mental health services and recovery. Complete one of the following sentences or write your own: Mental health services are an investment in recovery. I'm living proof. Mental illnesses are common and recovery is possible. Many people have mental illnesses like mine. With mental health services, people can experience recovery. Author: NAMI MinnesotaYou can sign up for NAMI Minnesota's Legislative updates here. COVID-19 is making almost everything more difficult, including mental health advocacy at the state legislature. With a remote session, we have to do more to effectively engage legislators. NAMI Minnesota is doing their best to represent people with mental illnesses, but your help is needed if we are going to have a successful legislative session and pass bills to build our mental health system. The most powerful tool you have as an advocate is your personal story. (Click to Tweet) You don't need to know all the facts, all you need is your personal experience with the mental health system and your insight into the parts of our system that are working or need improvement.
These are just a few areas where they could use your insights. Telling your story is important and it's easier than you might think. All you need to do is capture the following details in one page or less:
A story can be anonymous if you like, or you can just use your first name if that's what you're comfortable with at this time. Once you've written your story, please send it to namihelps@namimn.org. If you'd also like it to be considered for publication on this blog, send it our way as well at namiwashingtoncounty@namimn.org. Thank you for joining our advocacy team as a storyteller! Author: NAMI MinnesotaYou can sign up for NAMI Minnesota's Legislative updates here. |
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