Everyone knows that their health insurance is supposed to cover physical injuries. You fall down, you get hurt, you go to the doctor, and you submit the bill to insurance. You get a cough, you go to the urgent care center, you get medicine, and the cough goes away. People don’t worry about whether their insurance company is going to take their claim seriously, or pay a lesser percentage of the bill, or limit the number of visits to the doctor.
The same can’t be said for mental health care. Many people won’t, or can’t, seek mental health treatment because their insurance company won’t provide the same levels of coverage as it does for a physical sickness or injury. Some people are also worried about the “stigma” of seeking appropriate mental health services.
Although there have been prior efforts to mandate equal treatment of physical and mental health services by the insurance industry, Governor Murphy signed a State Law on April 11, 2019, that will mandate stricter enforcement of these laws by directing health insurance providers to provide the same coverages-including co-pays, deductibles, in- and out-of-network options, and the number of office visits-as they do for physical injuries and sicknesses. The carriers will be obligated to submit an annual report to the New Jersey Department of Banking and Insurance to show their compliance with these equal coverage laws. The law also applies to coverage for substance abuse.
The New Jersey law also obligates insurance companies to meet the requirements of the
Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act; which was a Federal statute passed in 2008 with similar requirements.
The new law covers a broad range of health care providers, both public and private, and was supported both parties.
While most people won’t notice any changes, some people, perhaps those most in need, should be able to find more affordable and broader treatment options.
Written by Larry Kroll, Attorney At Law, April 12, 2019