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July, 1987, Vol. 110, No. 7
Mental health benefits
financed by employers
Although most employer-financed health insurance plans cover mental disorders, benefits have traditionally been more restricted than for other illnesses. Coverage for mental disorders is usually for shorter periods and maximum dollar benefits are often lower. Also, plans commonly pay a smaller share of mental health care expenses.
These differences are more pronounced for outpatient mental health care. Coverage of mental health care in a hospital is the same as for other types of hospital care for four-tenths of the employees in medium and large private firms; outpatient mental health care is almost always subject to stricter limits than other illnesses.
Several reasons are commonly advanced for treating mental health care differently than other types of medical care. One reason is that mental disorders are not as easy to define as other illnesses.1 Also, mental health problems can be subjective, with treatment continuing for an indeterminate period than when confinement is caused by other illnesses. These characteristics are often extended to outpatient care, when treatment may be highly elective on the part of the health insurance subscriber.2
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1 Sam Muszynski, Jo Brady, and Steven S. Sharfstein, M.D., comps. Coverage for Mental and Nervous Disorders: Summaries of 300 Private Sector Health Insurance Plans (Washington, American Psychiatric Press, Inc., 1983), ch.2
2 Jerry S. Rosenbloom and G. Victor Hallman, Employee Benefit Planning (Englewood Cliffs, NJ, Prentice Hall, Inc., 1986), pp. 134-35. For a contrary view, see Trends in Health Insurance Coverage for Mental Illness (Washington, The National Association of Private Psychiatric Hospitals, 1986); John C. Garner, "Consider Outpatient Mental Benefits," Business Insurance, Dec. 23, 1985, p. 39; and Jeffrey A. Buck, "Should Mental Health Care Services Be Structured Like Medical Care?" Inquiry, Fall 1982, pp. 211-21.
Related BLS programs
Employee Benefits Survey
Related Monthly Labor Review articles
Employer-sponsored health insurance: what's offered, what's chosen?—Oct. 1995.
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