Insurance Farce
WARNING: This is going to be an angry, frustrated, rant about the state of the health care system in this country and New York State in particular. If you don’t want to read a rant, then
close your browser or click a link to go someplace else. In 2006 New York State passed a law called the “2006 Mental Health Parity Legislation” or “Timothy’s Law”. It is called Timothy’s Law because it was the suicide of Timothy O’Clair in March 2001, seven weeks prior to his 13th birthday, who was discriminated against by his parents insurance company that started the movement to get it passed. It is, in concept a great law. Simply stated it requires private health insurance to cover mental health issues at the same level they cover regular medical issues. Here is a quote from the Timothy’s Law website
:
Timothy’s Law mandates that insurance providers covering any health care services must also provide coverage for mental health and substance abuse services, and that coverage and cost must be ‘on par’ with all other health care services covered under such policy.
Since the majority of insurance policies do not offer this type of coverage you would think it was a wonderful and great thing they did, and it is. Except as with any law, especially ones in NY and ones dealing with the insurance companies, there are loopholes. Big, huge, gaping ones that you could march an army through. Here are the two biggest ones as far as I can tell. It only applies to group health insurance or school blanket insurance that is obtained through an employer or association. What the hell does that mean you ask? It means that if you get your insurance through a group policy from work, it *might* apply to you. If you get your insurance through an association, such as a Chamber of Commerce, union, etc., it *might* apply to you. However, if you buy insurance on your own or use one of the publicly funded or subsidized programs such as Healthy NY, Child Health Plus, Health Care Plus, etc, you are screwed. No mental health coverage for you. Now, if you make it past that first obstacle and have a policy that meets those requirements there is one more HUGE loop hole that you have to get past. The law only applies to policies that are WRITTEN in New York. Now I am not an expert, but from what I have been told and found out the state that the policy is written in has nothing to do with the state the people covered live in or the company buying the policy (ie: your employer) is located. Case in point, a company headquartered in Massachusetts has and insurance policy for residents of New York state that is “written” in Florida and administered by a company in Kentucky. Now some of you who live in other states or know about these things would say “But Rich, if the insurance coverage is mandated by your state law, the insurance company has to abide by that mandate.” And you know what, in many cases you would be correct. However, there is apparently some national level reciprocation agreement that states have the option to participate in. Sort of a “you wash my back and I will wash yours” thing. If the state where the person lives and the state where the policy is written both participate in the program, you are covered. Guess what, New York State doesn’t participate. So you can join the other people who are screwed. Now there is one other option for those that do not want to be completely at the mercy of the system, and that is a program called Family Health Plus. A program that to get into you need to do an hour long in-person interview, provide financial data on every member of your household, and wait 2 months for approval. Oh, and you have to pick one of the plans that has the coverage you need and there are income requirements that anyone who makes more money than Unemployment pays probably exceeds. So in a nutshell, if you live in New York State and have medical insurance that doesn’t cover mental health issues and it was written in a state other than New York… you better hope you never have a mental health issue. Like anxiety and stress related to the fact that you don’t have mental health coverage….. UPDATE: A friend posted this link over on Facebook and I thought it timely…. http://awesome.goodmagazine.com/goodsheet/images/goodSheet_002_BillofHealth.jpg
Bill of Health Goodsheet from Good Magazine
