Insurer Undermines Importance of Mental and Behavioral Health

United Healthcare recently lost a class action suit filed by 50,000 patients who were denied Mental and Behavioral health coverage by United Behavioral Health. In it the judge blasted United for putting its ‘bottom line’ over patient’s health. The practice probably came as a shock to just about no one, but now there is a legal victory in the books that might force insurers to provide the care they claim to.

In the original reporting on March 6th 2019, Wayne Drash of CNN reported: “In a scathing decision, a federal judge blasted a subsidiary of the nation’s largest insurance company for focusing on the “bottom line as much or more” than patients’ health, saying the insurer illegally denied treatment to thousands of people. The judge also slammed the company’s medical directors for being “deceptive” under oath.

US Chief Magistrate Judge Joseph Spero issued his decision Tuesday against United Behavioral Health, a unit of UnitedHealthcare, saying the insurer created internal policies that effectively discriminated against those seeking mental health and substance abuse treatment.

“It is well-established that effective treatment of mental health and substance use disorders includes treatment aimed at preventing relapse or deterioration of the patient’s condition and maintaining the patient’s level of functioning. UBH Guidelines deviate from that standard,” Spero said.”

See the full article here.

We shared CNN’s article with some of our patient advocates and here are some of their responses:

Callum Radley: ankylosing spondylitis advocate

Some of my therapy and psych appointments are covered by United Healthcare but it’s always an obstacle course trying to find someone in my network. They don’t have an easy list of providers and it’s like a 4-day process to find someone within your network, which requires 3-5 phone calls. After you call United initially, they interview you to “help” find a specialist to meet your needs but the questions they ask in that process are super invasive and not anything I would share to someone who isn’t a professional. They also stopped covering my old psychiatrist without informing me and now I owe nearly a grand for something that should have cost less than $100. Hate United with a passion.

Diane Talbert: psoriasis advocate

It’s truly sad. These insurers won’t give us a break. The public seems aware something is wrong with our mental health care system but there’s not focused effort to try to tackle this situation. A clear indication of just how separately they channel resources and treat the mentally ill in our insurance system, flip over your own health insurance card – some have a different phone contact for mental health and addiction services. They’re not treated like medical needs, they’re ‘something else’.

This needs to get better. The sad part is that while we sit on our butts, emergency rooms and prisons overflow with the mentally ill and suicide rates get higher. Let’s work together to try and fix this!!!

We also shared it on our Facebook page

and here are some of the comments from our audience there:

  • “As long as our medical care is profit-driven, patient-care will always be a secondary consideration.”
  • “We have … Medicare Advantage, it pays up to $2,000 each year with no copay for dental, extractions, fillings, crowns, dentures, cleanings etc. I’m 83 years old. No copay for one vision exam each year too.”
  • “More companies are being investigated! AETNA needs (to be) investigated for sure!”
  • “They say you will get all that Medicare gives plus more. Try getting in patient rehab to meet your needs. You will get as little as possible and I mean less than benefit allows. Be prepared for a fight.”
  • “…by far the worst insurance I have ever had. We have their Medicare Advantage supplement – huge copays and they go to extreme lengths to not treat at least us seniors. I detest them but do not know anyone better. Their customer service by phone is a nightmare. I got thrown back in the queue 3 times last week but different reps trying to help 45 minutes. I finally asked them to just mail the information no one seems to know how to look at information.”

Have you had difficulty accessing Mental or Behavioral Health services through your insurer? Tell us.

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