Health Insurance Coverage for Mental Illness | CTFA Exam Prep

Health Insurance Coverage for Mental Illness

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Question

Many health insurance plans omit or offer only reduced benefits for treatment of mental disorders. For example, a health insurance policy may offer hospitalization benefits that continue to pay as long as you are hospitalized except for mental illness. It may restrict payment for mental illness to one-half of the normally provided payment amounts and for a period not to exceed:

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A. B. C. D.

C

Many health insurance plans have historically provided limited benefits for treatment of mental health disorders compared to other medical conditions. This is commonly referred to as mental health parity, which is the concept that insurance benefits for mental health treatment should be equal to those for physical health treatment.

One way in which mental health parity may be lacking is through reduced benefits for hospitalization related to mental illness. The question describes an example of a health insurance policy that offers hospitalization benefits that continue to pay as long as the patient is hospitalized, but with reduced benefits for mental illness. Specifically, the policy restricts payment for mental illness to one-half of the normally provided payment amounts and for a limited period of time.

The question asks for the maximum period of time that the policy will provide reduced benefits for mental illness hospitalization. The answer choices are 15 days, 20 days, 30 days, and 25 days.

To answer the question, we need to determine which of the answer choices represents the limited period of time for which the policy provides reduced benefits for mental illness hospitalization. The question states that the policy restricts payment for mental illness to one-half of the normally provided payment amounts and for a period not to exceed this limited time period.

The correct answer is therefore the answer choice that represents the maximum limited time period for reduced benefits. Based on the answer choices, the correct answer is A) 15 days. This means that the policy will pay reduced benefits for mental illness hospitalization for a maximum of 15 days, after which it will pay the normally provided payment amounts for hospitalization.

It is worth noting that mental health parity laws have been enacted in many countries, including the United States, to address disparities in insurance benefits for mental health treatment. These laws require insurance plans to provide equal benefits for mental health treatment compared to physical health treatment, including for hospitalization.