PMID: 12529560Jan 17, 2003Paper

Trends in mental health insurance benefits and out-of-pocket spending

The Journal of Mental Health Policy and Economics
David R McKusickJames S Genuardi


Insurance benefits can have a large effect on whether one is able to access health care services. Mental health and substance abuse (MHSA) insurance coverage has typically been less generous than that of general health services. This paper examines trends in the generosity of private insurance benefits for mental health (MH) services in the United States from 1987 to 1996. The paper estimates the benefit-induced change in insurance payments for MH services that would have been made by typical health plans between 1987 and 1996 holding constant utilization of individuals at the 1987 level so that the changes in effective benefits could be isolated. Trends in mental health benefits were measured using two nationally representative household surveys of the U.S. civilian non-institutionalized population, the 1987 National Medical Expenditure Survey (NMES) and the 1996 Medical Expenditure Panel Survey (MEPS). Data on utilization and expenditures from the NMES/MEPS were used to simulate what the average person would have paid out-of-pocket under typical insurance plans in 1987 and in 1996. The study finds that limits on MH coverage, such as limits on reimbursed days of care, became more prevalent from 1987 to 1996, but that consumer ...Continue Reading

Related Concepts

Diagnosis, Psychiatric
Expenditures, Indirect
Financing, Personal
Insurance Benefits
Insurance, Psychiatric
Mental Health Services
Reimbursement Mechanisms
Utilization Review
Cost-Sharing Insurance

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