Despite having insurance coverage, the out-of-pocket costs were still prohibitive, and she struggled to find someone who could provide appropriate care within her network. “I can only imagine how much harder it is for adults seeking mental health treatment,” she said.
The challenges in accessing mental health care have only been exacerbated by the COVID-19 pandemic, which has led to increased rates of anxiety, depression, and substance use disorders. According to the Mental Health in America 2024 report, 1 in 4 adults with mental illness reported that they were unable to access the care they needed due to cost.
The rollback of the 2024 regulatory updates to the Mental Health Parity and Addiction Equity Act is a significant setback for mental health care in the United States. It not only undermines the progress made in ensuring equal coverage for mental health and substance use disorder services but also threatens to reverse the gains in access to care for millions of Americans.
As advocates like Andria Donaghy and Deborah Steinberg continue to push for better mental health parity laws and increased access to care, it is clear that the fight for equitable mental health treatment is far from over. The mental health of millions of Americans hangs in the balance, and it is essential that policymakers prioritize the well-being of their constituents by ensuring that mental health care is accessible, affordable, and of high quality. Aetna’s Broken Promise: The Frustration of Dealing with Insurance Companies
Jenn and her husband were promised a certain rate of reimbursement by Aetna for the applied behavior analysis treatment they were receiving. However, three months into the treatment, Aetna drastically dropped that rate without any prior notification. This sudden change left Jenn feeling frustrated and helpless, as she tried to navigate the confusing world of insurance.
“They just changed their minds and said, ‘Nope, we’re actually gonna reimburse you at a significantly lower rate without any prior notification,’” said Jenn, a physician who provided documents to STAT showing the rate change. Despite making appeals to Aetna, they were denied, leaving Jenn and her husband struggling to cover the costs of their treatment.
After months of back and forth with Aetna representatives, Jenn decided to take matters into her own hands and filed a complaint with the New York attorney general. She was tired of the opacity and care disparity that is all too common with insurance plans.
“I’m someone who is educated, who’s knowledgeable in the health care field,” said Jenn. “Despite all of those things and my best efforts, best arguments, and appeals, insurance plans will still ultimately do what they want to do. It’s egregious, and it’s not fair.”
Jenn’s story is unfortunately not unique. Many individuals and families find themselves at the mercy of insurance companies when it comes to receiving the care they need. The constant battle for fair and transparent coverage can be exhausting and disheartening.
As Jenn continues to fight for fair reimbursement from Aetna, she hopes that her story will shed light on the struggles that many face when dealing with insurance companies. The lack of communication, sudden rate changes, and denial of appeals only add to the stress and burden that individuals and families already face when seeking medical treatment.
In a system that is supposed to provide care and support, it is clear that there are still many issues that need to be addressed. Until then, individuals like Jenn will continue to fight for fair treatment and reimbursement, hoping for a day when insurance companies will prioritize the well-being of their members above all else.
