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Mental Health Coverage-Parity and Annual Maximums November 11, 2009

Posted by Admin in Health Insurance, Healthonymous, Money.
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A friend of mine will be released from the hospital soon. This friend has been there for just over two weeks. The insurance coverage ran out on the 6th day. When my friend goes home, they will not be able to return to work full time-at least right away and there will be huge out-of-pocket expenses. The reason the insurance ran out is because the stay was for in-patient mental health treatment, which has an annual cap. The annual coverage maximum was reached on the sixth day, but my friend was not medically ready to be discharged on that day.

So they are facing at least 8 days of bills for treatment, plus the opportunity cost of lost wages, during the treatment and after being discharged. I’m guessing $1000 per day. The bill is in $25,000 for 8 days!

To my friend’s credit and also  the medical staff’s, the stay did not end when the insurance coverage ran out. My friend is struggling and checking into the inpatient facility was actually the healthy thing to do in this case.

I don’t know the specifics for this particular insurance policy, but an important issue in mental health coverage is parity. Parity means the same level of coverage for mental health as there is for medical surgical procedures and illnesses. There is existing legislation about this issue in the US. But beware if you work for a “small business”. See below-

The Dept of Labor Fact Sheet describes the legislation this way:

The Mental Health Parity Act (MHPA), signed into law on September 26, 1996, requires that annual or lifetime dollar limits on mental health benefits be no lower than any such dollar limits for medical and surgical benefits offered by a group health plan or health insurance issuer offering coverage in connection with a group health plan. MHPA applies to group health plans for plan years beginning on or after January 1, 1998.

Naturally, there are some exceptions:

MHPA applies to most group health plans with more than 50 workers. According to Federal Standards, MHPA does NOT apply to group health plans sponsored by employers with fewer than 51 workers. Source

To learn more about laws in the 50 states, visit the web page for the National Council of State Legislatures site here.

My friend’s next challenge will be  (more…)


Left Government vs. Right Government November 9, 2009

Posted by Admin in Health Insurance, Healthonymous.
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>Left and right view of the US


Where Do You Fall

How you feel about the recent US House health care bill (HR 3962) might depend on where you see yourself on this chart?

It appears in a book being released today (Nov. 10th, 2009) in the US. For information on the book click here.

Consider the following beliefs about society from the chart:

Left:  One for all and all for one

Right:  Survival of the fittest

These contrasting beliefs make it impossible to argue with some R’s or   Libertarians (we have several in the family) about health care reform or almost any government role save defense. I remembered this when I read a review of two biographies of the famous “radical individualist”, Ayn Rand, this past weekend. Some of her books were in my childhood home and I did read The Virtue of Selfishness, The Fountainhead and Atlas Shrugged as an impressionable “tween”.  But I grew up. Now I am a passionate, citizen activist, progressive, government-loving liberal so I guess I wasn’t too tainted. The “radical individualists” in my family live and breathe their ideology.

I’m not saying that it is bad to be an ideologue, but it is a lonely place. For my relatives, it has just gotten lonelier, as most of the family email list has gotten fed up. The errant relatives have told us we can’t see the truth and “we ignore it at our peril”. But this quote from Ms. Rand tells me that this is all part of the plan:

The hardest thing to explain is the glaringly evident which everybody had decided not to see.” source (more…)

Take 2 Tax Breaks and Call Me in the Morning November 7, 2009

Posted by Admin in Diary, Health Insurance, Health Quote of the Week.
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So said Rep. McGovern (D-Mass.) moments ago in the floor debate on HR 3692 in the House of Representatives. That was his characterization of the health care reform that the Republicans would prefer.

[picapp src=”6/9/6/2/Hillary_Clinton_Campaigns_fe19.jpg?adImageId=7201356&imageId=3717859″ width=”234″ height=”318″ /]

The R’s have a new tactic this morning. After the increase in the unemployment rate was announced yesterday, they are now calling HR 3692:

a job-killing (4 million free-enterprise jobs), debt-piling, small business tax increasing, major overhaul of health care delivery in this country.

Meanwhile, the D’s are reminding constituents that:

the bill invests in prevention, wellness and public health, according to Rep. Doris Matsui (D-CA). She also reminded us that this bill will prevent medical bankruptcies and close the “donut hole” of Medicare Part D.

[picapp src=”a/c/5/5/Sen_John_McCain_e5e6.jpg?adImageId=7201443&imageId=6922532″ width=”234″ height=”351″ /]Other Representatives from the majority party have alluded to our poor infant mortality statistics, the bills mandate to not deny people care based on  pre-existing conditions such as being female, having had a C-section, being a victim of domestic violence or being a cancer survivor, and the 100 year debate on this issue.

Rep. Mary Jo Kilroy (D-Ohio) fights back by saying,

It’s time to make coverage accessible and affordable. We’ve waited too long…..

Presiding over the House debate today is Rep. Charles Dingell (D-MI), who presided over the debate on the Medicare legislation in 1965.

Watch the debate live on C-SPAN or cspan.org now!

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