Abstract
To examine the nature and extent of private insurance coverage available for health services needed by six hypothetical adolescents with physical and mental health conditions. Health insurance information was obtained from the most commonly sold product of the largest health maintenance organization (HMO) and preferred provider organization (PPO) in each state and the District of Columbia. Contract documents were collected in 1999 and were in effect at the end of 1998. Our response rate was 97% and included 49 HMOs and 49 PPOs. The extent of coverage was analyzed according to benefit availability, structure, limits, and protections, as well as condition and treatment restrictions. The two hypothetical adolescents with asthma and depression had coverage for their recommended health services in most of the 98 plans. However, the four hypothetical adolescents whose conditions included pregnancy and sexually transmitted disease, anorexia nervosa, injury, and substance abuse and bipolar disorder would rarely have access to coverage for all of their recommended services. Ancillary and behavioral health therapies were least likely to be available in the amounts considered necessary by medical experts. All of the hypothetical adolescen...Continue Reading
References
Jan 1, 1992·Health Affairs·L L Prina, J H White
Jan 1, 1996·Health Affairs·G AcsP F Short
Aug 28, 1998·MMWR. CDC Surveillance Summaries : Morbidity and Mortality Weekly Report. CDC Surveillance Summaries·L KannL J Kolbe
Mar 26, 1999·Health Affairs·J A BuckM Stein
Aug 14, 1999·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·J D KleinK S Collins
Citations
Apr 27, 2005·The International Journal of Eating Disorders·Ruth H Striegel-Moore
May 4, 2005·Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners·Naomi A Schapiro
Feb 8, 2011·Academic Pediatrics·M Jane ParkCharles E Irwin
Aug 25, 2009·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·Abigail EnglishLawrence J D'Angelo
Sep 1, 2009·The International Journal of Eating Disorders·Tatiana Escobar-KochUlrike Schmidt
Nov 23, 2006·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·Kathleen RobergeauTomas J Silber
Sep 22, 2005·Health Services Research·Frederick J Zimmerman
Dec 23, 2008·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·Ramesh RaghavanJ Curtis McMillen
Mar 1, 2008·American Journal of Men's Health·David J Breland, M Jane Park
Oct 26, 2016·Transcultural Psychiatry·Rebecca J Lester
Jan 1, 2007·Crisis·Annette Beautrais
Mar 10, 2010·Journal of Youth and Adolescence·Nikeea Copeland-LinderNicholas S Ialongo
Aug 20, 2020·Health Economics·Eryn Piper BlockSusan L Ettner
Nov 22, 2016·Journal of Public Health Management and Practice : JPHMP·Madhurima SarkarDeena J Chisolm
Nov 3, 2005·Pediatrics·Michael D KoganBonnie Strickland
Apr 4, 2007·Pediatrics·Jonathan D KleinAndrew W Dick
May 9, 2012·Pediatrics·Christina A SuhAllison Kempe
Jan 2, 2009·Pediatrics·UNKNOWN American Academy of Pediatrics Committee on Adolescence, UNKNOWN American Academy of Pediatrics Committee on Child Health Financing