The vast majority of insurers and health plans cover at least a limited amount of mental health care. According to a recent employer survey published in the journal Health Affairs:

• 91 percent of small firms (10-499 employees) and 99 percent of large firms offer mental health and substance abuse coverage in their most used medical plans.

• Mental health and substance abuse coverage was included in 87 percent of indemnity plans, 88 percent of HMOs (Health Maintenance Organization), 97 percent of Point of Service (POS) plans and 93 percent of Preferred Provider Organizations (PPOs).

Most employees who have employer-based health insurance have access to mental health coverage, and many of the employees who don't have coverage choose not to join an employer's plan that includes mental health care.

There are limits to mental health coverage and the reason why most employers impose limits is due to cost.  Estimates vary widely of how much more mental health coverage costs.  Here are some results from some studies:

• A 1998 study sponsored by National Advisory Mental Health Council (NAMHC) and Parity Workgroup, a division of the federal National Institute of Mental Health, estimated that mental health parity would add less than 1 percent to the cost of a health insurance policy for an HMO.

• A 1998 study by Mathematica estimated a 3.6 percent increase across all plans, with a range of 0.6 percent increase for HMOs up to a 5 percent increase for fee-for-service plans.

• A 1997 analysis by the actuarial firm Milliman & Robertson for the National Center for Policy Analysis, examining the cost of a typical mental health mandate (not specific legislation), concluded that mental health parity legislation tends to drive up costs by 5 percent to 10 percent.


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