How the Affordable Care Act Affects People with Mental Illness

By

Gina Garippo

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If you or a loved one has schizophrenia, you know that getting the right medical services is vital to your well-being. But finding and affording adequate care hasn’t always been easy.

Thankfully, healthcare options are improving for people with mental health issues. The Affordable Care Act (ACA) changes your healthcare rights and access to services. Below are a few ways the law affects people with schizophrenia and other mental illnesses.  

You Can’t Be Denied Insurance

In the past, health insurance providers could deny coverage to people with pre-existing health conditions. As a result, some people with schizophrenia went without insurance or were forced to pay higher premiums to get it. This reduced their overall access to care.

An estimated 24% of Americans with mental illness had no health insurance as recently as March 2013, before the ACA was implemented. People without health insurance are twice as likely to delay or skip needed medical care. With the new law, you are eligible for health insurance even if you have a mental illness.

Affordable Options Are Available

The ACA requires most people to have insurance, and affordable options are available under the law. If you don’t already have insurance, you can sign up through new state health insurance marketplaces, or “exchanges.” Or you may now be eligible for Medicaid, a government program that provides healthcare to low-income families. The ACA expanded the number of people who are eligible for this type of support.

There’s No Maximum Limit for Coverage

If you seek mental health care services, you no longer need to worry about running out of insurance benefits. Before the ACA was passed, insurance providers could set a lifetime limit on mental health expenses. Now, these limits are banned. This means that people with schizophrenia can get the care they need without fear that they’re using up their benefits.

Mental Health Services on Par With Other Medical Services

In the past, health insurance providers weren’t required to provide mental health services in every insurance plan. If they did, the services didn’t need to be covered at the same level or rate as medical services. Under the ACA, mental health services must be included in all insurance plans. And they don’t take a back seat to medical care.

Preventive Care Is Free

Just like everyone else, people with schizophrenia need regular preventive medical care for good health. Under the new law, all preventive healthcare services are free. This includes preventive care visits, depression screenings, cancer screenings, and more. It also includes programs to help you quit smoking. An estimated 75% to 90% of people with schizophrenia are addicted to nicotine. Taking steps to quit can greatly improve your health and quality of life.

To learn more about the ACA and your insurance options, visit www.healthcare.gov.

Key Takeaways

  • Under the Affordable Care Act, health insurance providers can’t deny you coverage if you have a mental illness.

  • There’s no maximum limit for coverage, so you no longer need to worry about running out of insurance benefits.

  • Mental health services must be included in all insurance plans.

  • All preventive healthcare services are free, including programs to help you quit smoking.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 11, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Tobacco Cessation Treatment: What is Covered? American Lung Association, Accessed Feb. 12, 2014 (http://www.lung.org/stop-smoking/tobacco-control-advocacy/reports-resources/2012/hsq-what-is-covered...;
  2. Health Reform and Mental Health, National Alliance on Mental Health, Accessed Jan. 27, 2014 (http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Public_Policy/Issue_Spotlights/NAMI...;
  3. Schizophrenia, National Institutes of Mental Health, Accessed Jan. 27, 2014 (http://www.nimh.nih.gov/health/publications/schizophrenia/schizophrenia-booket-2009.pdf);
  4. Health Care that Works for Americans, The White House, Accessed Jan. 27, 2014 (http://www.whitehouse.gov/healthreform/healthcare-overview);

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