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Will Your Kid’s Mental Health Treatment Be Covered? [SERIES]

In part four of our series “NJ Children Confronting Mental Illness,” we learn that many conditions are not covered completely, and some are simply ignored by the insurance companies.

If your child is diagnosed with a mental condition, you probably expect your health insurance to pay for treatments, but that might not be the case.

“Not every single disorder is covered to the same extent as medical disorders are, and if insurance does not cover the type of treatment that your physician thinks you need, you could be in serious trouble,” said Debra Wentz, CEO of the New Jersey Association of Mental Health and Addiction Agencies.

She said despite laws that have been passed that are supposed to make coverage of mental health disorders similar to physical health problems, “their implementation of the coverage does not cover all the treatment that’s needed and the kinds of treatment that’s needed.”

“You can’t have limitations on treatment,” added Wentz. “It would be like saying after someone had a heart attack, ‘well this is your third heart attack, and we’re not going to cover you anymore.’”

New Jersey Assemblyman Reed Gusciora believes the problem is serious and needs to be addressed, so he’s sponsoring legislation that calls for mental diseases to be treated the same way as physical diseases are.

“Something as minor as an eating disorder, that is not treated, often snow-balls into more mental problems, depression, and often suicide attempts,” he said. “Without treatment, these conditions will get compounded and become even more serious.”

His measure would actually be a money-saver, because “if we can treat people early they can lead productive lives, finish school and not become involved in criminal activities.”

“In order to really help people with many mental health disorders, we’re going to have to do a lot of work to broaden the definitions that insurance companies have,” said Wentz.

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