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Photo of David Dopkin

Class action points out flaw in mental health coverage

On Behalf of | Apr 10, 2013 | Social Security Disability Benefits for Mental Conditions

Residents here in Texas know that there are some negative stigmas that surround mental health conditions. Because of the difficulties associated with diagnosis, and because mental conditions don’t always have visible symptoms, many people across the nation look at mental impairments with increased scrutiny.

But while we, for the most part, expect this from the general population, what happens when we learn that this same scrutiny is being applied by healthcare providers? What happens when the scrutiny from healthcare professionals and insurance providers denies a person needed benefits? What happens if that denial of benefits turns out to be in violation of federal laws?

A recent class action against the insurance company UnitedHealth Group intends on answering these questions this month. The complaint against the company, filed by a father whose son suffers from depression and a menagerie of other mental conditions, points out the inconsistencies in coverage for mental health claims versus medical or physical claims. Despite federal law prohibiting insurance companies from treating mental health claims differently physical or medical ones, the class action claims that the man’s son was not given the same fair treatment he would have received had his claim not been mental in nature.

But UnitedHealth Group isn’t the only insurer to have been called out on its questionable policies for mental health coverage. In last week’s post, we explained that many health insurance companies across the nation do not even coverage mental health conditions on their plans. Which boils the matter down to one question: who decides what qualifies as a disability and what is covered under insurance plans?

Ultimately, because of how the current laws are worded there is no clear answer. Because insurers are not required to cover mental health conditions under their policies, many people are left without financial assistance when it comes to paying for medical bills. And as some people have already pointed out, this problem can only get worse if nothing is done to solve it.

Source: The Star Tribune, “Suit against UnitedHealth tests mental health coverage rules,” Jim Spencer, April 6, 2013