Mental Health Questions to Ask During Open Enrollment

1. Who decides whether my family and I need a Mental Health benefit? Can I see a Clinical Psychiatrist or a Behavioral Psychologist on my own, or is coverage limited to a referral by my Primary Care Physician? How trained is the latter in diagnosing early stages of Mental Disorders? What if some physical symptoms have roots in the state of mind? Consider children as a special case as they may not express anxiety and related conditions in a manner to which adults, other than specialists, are accustomed.
2. How often can my family and I seek counsel and consultation? Are there limits on the number of visits per year? Are there some Mental Health disorders that are not covered or for which reimbursement and benefits are restricted? Are there exclusions for pre-existing conditions?
3. Who are the Mental Health Professionals in the local HMO? How much must I pay if I choose a specialist who I would like to consult? Is a child psychiatrist a part of the network to which I plan to subscribe? What are the credentials and track records of the doctors on whom I must rely for all of the next year, when it comes to Mental Health concerns?
4. Do doctors I choose to manage my Mental Health and that of my family have to send reports to My Health Insurance Company? Will such disclosure protect my rights to privacy? Whose view will prevail in the event of professional disagreement on diagnosis and course of treatment? What if I am dissatisfied with the network doctor?
5. Is there a window after I enroll, during which I have to pay for Mental Health services on my own? What are the dimensions and scope of such financial liability? What kinds of expenses related to treatment of Mental Health disorders are not covered in full? Will my policy pay for respite care and hospitals, apart from consultation and medicine? What if someone needs specialized care?
6. What are the annual and lifetime limits on how much can be spent on Mental Health? Are these adequate for the particular needs of my family and myself? How will I cope if unfortunately someone who depends on me becomes acutely or chronically ill in terms of Mental Health and needs expensive care on an on-going basis?

These questions are not hypothetical and impact severely on your critical Mental Health interests. Read a heart wrenching story on how the Texas legislature has ruled against Mental Health benefits for common people and the devastating effect this can have on families.

The fine print on a Health Insurance Policy may leave you in doubt about the scope and extent of benefits to which you are entitled. Ask questions of professionally trained Agents and choose a Policy only after you have understood the ramifications. Keep children in particular focus and read authentic sources to understand the special Mental Health needs of young people.

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