mental health coverage different? - Health Insurance Issues Message Board

brandi1971 · 11-30-2003, 08:25 PM

Hi- Does anyone know the laws in Illinois as far as mental health insurance? I know parity laws were passed here but I am having some problems finding out exactly what it means for health insurance now. Ordinarily, for counseling, we are allowed 30 outpatient visits per year. But I have heard that if you are diagnosed with certain things considered biological in nature, one of them being generalized anxiety disorder which is what my diagnosis is, they have to allow you more visits per year- oftentimes there is no limit- they have to treat it like they would any other health problem- no limit on visits and the same deductible etc. Anyway, if anyone knows what the Illinois laws are, could you help me with this? I have tried talking to some different organizations but am not getting much help. Thanks!!

picksie · 12-02-2003, 02:30 PM

Mental Illness - Serious
215 ILCS 5/370c(b)(1)
Public Act 92-0185
Effective January 1, 2002 Requires coverage of serious mental illness under the same terms and conditions as coverage for other illnesses and diseases. Serious mental illness is defined within the law. Coverage may be limited to 45 days of inpatient treatment and 35 outpatient visits annually.

I'm not sure if this is what you're referring to.... If not, here's a link to try... [url]http://www.ins.state.il.us/healthInsurance/Mandated_benefits.htm[/url]

picksie · 12-02-2003, 02:31 PM

Prior to January 2, 2001
Federal HIPAA Mental Health Parity Act of 1996 Applied Prohibited insurers and HMOs that offered mental health coverage from setting annual or lifetime dollar limits on mental health benefits that were lower than those for medical and surgical benefits. Mental health benefits were not required to be offered and plans were still allowed to set coinsurance amounts and limits on the number of visits or days of coverage. Applies to all group insurance policies except those covering small employers who have fewer than 51 employees. Sunsets December 31, 2002(Effective January 1, 1998

I lied, see above, lol!

brandi1971 · 12-02-2003, 03:21 PM

Thanks so much for the info!

rubindj · 12-02-2003, 07:25 PM

Brandi,

If this plan is through a large employer (51+ employees), the Illinois statue will not probably apply, just the HIPAA law. Congress co-opted all state laws as part of ERISA.

Sorry,
Dan