Health and Benefits

One of the first pieces of legislation to help people gain adequate access to mental health care was passed in 1996. This was when the Mental Health Parity Act was formed. It did not require a lifetime limit or annual dollar limit for mental health care benefits that were lower than medical benefits. However, insurers were allowed to choose maximum numbers for provider visits or limitations for the lengths of hospital stays. Legislation was passed several years ago to outlaw dollar limits. In addition to this, deductibles and copay amounts could not be more restrictive than those included in regular medical benefits.

PPO stands for Preferred Provider Organization. This type of insurance has “preferred providers” with whom they have contracted to provide care to plan members at a reduced cost to the insurance company. “Out-of-network” providers are all other providers not associated with the organization. Plan members may choose to see out-of network providers, but most likely will end up paying more money, either in the form of a higher co-pay or as a result of higher initial costs. . With PPOs, however, you may see any doctor you wish. You don't need a referral to see a specialist.