Substance Abuse Benefits: Still Limited After All These Years: Scanty coverage for substance abuse treatment flies in the face of adopting evidence-based treatment practices.
Abstract
Using data from a special supplement to the 2006 Kaiser/HRET Employer Health Benefits Survey, this study examines the state of employer-sponsored insurance substance abuse benefits in 2006 and how benefits compare to coverage for medical-surgical services. In 2006, 88 percent of insured workers had some coverage for substance abuse services. Current substance abuse benefits, however, do not provide the same protection afforded under medical-surgical benefits. Instead, substance abuse benefits are characterized by higher cost sharing and annual limits and lifetime limits on inpatient and outpatient care. These limits generally do not exist for other medical conditions and have increased since 1990.
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When families accessed MH/SUD services for their children, they were required to pay higher coinsurance amounts for MH/SUD services than for non-MH/SUD medical services.
“When families accessed MH/SUD services for their children, they were required to pay higher coinsurance amounts (ie, copays) for MH/SUD services than for non-MH/SUD medical services.”
From Parity and Out-of-Pocket Spending for Children With High Mental Health or Substance Abuse Expenditures (2013) · cites this paper as [7]
Historically, high out-of-pocket spending for a child's MH/SUD treatment has been due in part to benefit limits imposed by health plans.
“Historically, high OOP spending for a child’s MH/SUD treatment has been due in part to benefit limits imposed by health plans.”
From Parity and Out-of-Pocket Spending for Children With High Mental Health or Substance Abuse Expenditures (2013) · cites this paper as [7]
Families faced greater caps on the number of outpatient visits or inpatient days covered annually for MH/SUD treatment compared with non-MH/SUD medical services.
“Families faced greater caps on the number of outpatient visits or inpatient days covered annually for MH/SUD treatment compared with non-MH/SUD medical services.6,7”
From Parity and Out-of-Pocket Spending for Children With High Mental Health or Substance Abuse Expenditures (2013) · cites this paper as [7]
Cites
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McGinty, E. E., Busch, S. H., Stuart, E. A., Huskamp, H. A., Gibson, T. B., Goldman, H. H., & Barry, C. L. (2015) · Health Affairs · doi:10.1377/hlthaff.2014.1384 · Cited by 79 · see citing works
Barry, C. L., Chien, A. T., Normand, S.-L. T., Busch, A. B., Azzone, V., Goldman, H. H., & Huskamp, H. A. (2013) · Pediatrics · doi:10.1542/peds.2012-1491 · Cited by 20 · see citing works
- Authors
- Gabel, J. R., Whitmore, H., Pickreign, J. D., Levit, K. R., Coffey, R. M., & Vandivort-Warren, R.
- Affiliations
- Substance Abuse and Mental Health Services Administration (US)
- ORCID
- Pickreign, Jeremy D.
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2007-01
- Volume
- 26
- Issue
- Suppl2
- Pages
- w474-w482
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- OpenAlex
- W2150805029
- Cited by
- 23
- References
- 1
- Citations by year
- 2019: 2 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 6.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
- Keywords
- employer-sponsored health insurance, health insurance coverage, cost sharing, inpatient and outpatient care
- MeSH terms
- Health Benefit Plans, Employee, Humans, Insurance Benefits, United States, Cost Sharing, Health Care Surveys, Substance-Related Disorders
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