Affordable Care Act and Parity for Addiction in 2014: Praise for Some but Not All
News on the Affordable Care Act and what it means for addiction treatment
Over the years we had many clients who paid cash for treatment because they could not get insurance for substance abuse treatment due to “pre-existing conditions.” That legally changed on January 1, 2014 thanks to the Affordable Care Act which abolished the notion of withholding insurance coverage due to “pre-existing conditions.”
Also on January 1, 2014 the Affordable Care Act began enforcing The Mental Health Parity and Addiction Equity Act of 2008. The intent of the Parity Act was to end the long-standing financial requirements and treatment limitations many insurance companies and health care policies placed on mental health and substance abuse treatment. Parity is now law.
We begin with a salute to Health Net of California and Arizona. In 2014 we admitted approximately 20 clients who had personal Health Net Platinum PPO policies. Most of these clients had never before been able to get treatment for long-standing substance abuse issues. And while the premium is not cheap, Health Net follows the intent of the parity act and authorizes the type of long-term treatment alcoholics and addicts need to get into long-term recovery. We believe the outcomes of their policy, seen over three years, will be significantly better than outcomes of other California providers.
We also salute Florida Blue Cross/Blue Shield. Although our past experience is that this “Blue” has to be prodded to pay correctly and on time, we admitted a patient with a Florida Blue Select 1457 private policy, a private payment plan not unlike Health Net Platinum. Blue Select paid according to the benefits quoted and followed the intent of parity.
We can also report we had limited but good experience with a Premera Blue Cross/Blue Shield personal Gold 1000 PPO. This was for a client from the State of Washington, but residents or Oregon and Alaska are apparently also eligible for this PPO plan.
You can find information about these plans, and agents who can sell them, by clicking here.
Unfortunately we struck out when helping alumni and possible admits search for personal plans with good out- of-network substance abuse treatment benefits in states as diverse as Oklahoma, Pennsylvania and New Jersey.
This is a topic with a lot of discuss, we’ll continue in Part 2 of this series.