May 27, 2010

Dr. Katherine C. Nordal on Using Insurance to Cover Mental Health Treatment

Questions for psychologist Katherine C. Nordal, PhD, on using insurance to cover mental health treatment.

Reporters/editors/producers Note: The following feature was produced by the American Psychological Association. Feel free to use it in its entirety or in part; we only request that you credit APA as the source. We also have a photograph of Dr. Nordal available to reprint.

May is Mental Health Awareness Month. According to the National Institute of Mental Health, about one in four adults have a diagnosable mental disorder in a given year in the United States. And about 6 percent of adults in the United States suffer from serious mental illness. Many Americans do not receive treatment. We spoke with Dr. Katherine Nordal, APA’s executive director for professional practice about using insurance to cover mental health treatment. This is the last of a four part series in recognition of Mental Health Awareness Month.

Dr. Nordal is a licensed psychologist experienced in treating adults, children and adolescents and has clinical expertise in the treatment of stress-related disorders. As executive director for the APA’s Practice Directorate, Dr. Nordal manages a variety of activities involving legislative advocacy, legal initiatives, efforts to shape the evolving health care market, and a nationwide public education campaign, including the Mind/Body Health Campaign, to enhance the value of psychology. Dr. Nordal is a recipient of the APA’s Karl F. Heiser Presidential Award for advocacy on behalf of Psychology. She was an APA/AAAS Congressional Science Fellow (1990-91) and served as a legislative assistant in the U.S. House of Representatives and with the House Select Committee on Hunger. Her clinical interests included: learning, behavioral and emotional disorders in children and adolescents; neuropsychological assessment; brain injury in children and adults; and civil forensic psychology.

Q. Does insurance typically cover mental health treatment?  Do insurance companies typically provide different coverage for mental health treatment than physical conditions?

Many people don’t know much about the coverage offered by their health plan for mental health until they need services.  But the good news is that most health insurance plans provide coverage for mental health treatment and, following the passage of the Mental Health Parity and Addiction Equity Act of 2008, by law the coverage they provide must be equal to the coverage provided for physical conditions.

Thanks to this new law, which took many years of hard work by mental health advocates including APA, insurance plans can no longer discriminate against people with mental health disorders by requiring different co payments, separate deductibles or arbitrarily lower numbers of treatment sessions or days. 

If you don’t know the details of your health insurance plan, ask your benefits manager for a copy of your health plan benefits.  You have a right to a copy of your own. This document should describe what mental health and substance use treatment benefits you are entitled to.  It should also explain how to get services and how to appeal coverage decisions if necessary and explain what your financial responsibilities are.

Q. What impact does the health care reform bill have on coverage of treatment for mental health disorders?

The health care reform law will extend health insurance coverage to 32 million Americans by 2018. This is tremendous news for the health care system in this country and particularly for those who are currently uninsured or underinsured.

Those individuals and families who have employer-sponsored health coverage will be helped by insurance reforms that better regulate health plans, requiring the bulk of premiums to be spent on actual patient care rather than administrative overhead. They will also benefit from a ban on discrimination against those with preexisting conditions.  This year small employers will begin to get tax credits to provide health coverage and young adult children will be kept on parental health plans.  In 2014, all plans sold in the new health plan state “exchanges” will have to include mental and substance use disorder services at the same level as for physical services.  Those persons newly enrolled in Medicaid will have access to the same benefit package.

The American Psychological Association, in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 152,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.