Reprinted from the Health District's quarterly publication mailed to district residents (fall 2000)

Mental illness is the world's second leading cause of disability, stated the Surgeon General in a report issued last December. Yet mental illness is one of the most successfully treated diseases when identified early and treated appropriately.

Colorado law requires group plans to cover six biologically based mental illnesses — major depressive, bipolar, obsessive-compulsive, schizophrenia, schizoaffective and panic disorders — in the same way they cover physical illnesses. Unfortunately, some plans are exempt from this law. For example, a group insurance policy issued in another state may not offer these benefits to plan enrollees in Colorado. Also exempt are individual plans (plans not offered through an employer or other group) and those offered by large companies that are self-insured. 

When choosing a health insurance plan, be sure to ask: does this company provide coverage for the required six mental health diagnoses? 

Your insurance should also provide benefits for more prevalent problems, including attention deficit and anxiety disorders, sub-major depression and behavioral problems, such as substance abuse or eating disorders. 

Tom Barrett, PhD, director of Colorado Mental Health Services, asserts that a good plan will cover mental health benefits to the same extent that it covers physical benefits. "Often there are limits on the number of visits you're allowed, or the plan requires larger copays for mental health. We consider that discriminatory. Mental illnesses are legitimate illnesses just like physical illnesses and should be covered the same."

When selecting health insurance, it's up to you to ask questions about the extent of mental health benefits for each plan you consider. How much is covered, and how much is your copay? Are both inpatient and outpatient care covered, and if so, for how long? Can inpatient coverage be converted for use in an outpatient plan?

"Also significant, particularly with HMOs, is the network they offer," stresses Monica Smith, interim administrator of Mountain Crest Hospital in Fort Collins. "How many providers serve your area? Do you need to travel a considerable distance to get the care you need? Establishing a good relationship with your care provider is crucial to successful treatment, and limited networks can make this difficult. Also, do they deal with children? Adolescents? Kids have unique problems and special needs."

Make sure you have a choice of practitioners, including psychiatrists, psychologists and social workers. And since many mental health problems are treated most successfully with a combination of therapy and psychiatric drugs, find out which drugs, if any, are covered under your plan. 

Be an assertive health insurance consumer. Check any plan you’re considering carefully.