The Maryland Parity Project has developed a fact sheet for state marketplace Consumer Assistance Workers to guide behavioral health consumers with plan selection. The fact sheet was developed in response to calls to the Maryland Parity Project from providers and consumers about the difficulty consumers were having accessing care through their qualified health plans. Callers explained that consumers purchased plans with high deductibles and were shocked about their plan’s out-of-pocket costs once they attempted to access care. Most consumers did not thoroughly understand the plan they were purchasing, including the implications of the deductible.
Before Plan Selection
The fact sheet details how health insurance documents, such as the Summary of Benefits and Coverage and the prescription drug formulary, can be used to ensure the plan meets the needs of the consumer.
Following Plan Selection
After a consumer selects a health plan through the marketplace, he/she must understand their policy. The fact sheet also lists the rights of behavioral health consumers when accessing care through their insurance carrier. If a consumer feels his/her rights are being violated, the Maryland Parity Project can assist.
The fact sheet includes a worksheet with an example showing consumers how they might project total plan costs. In the example, Kate chooses a plan based on lower premium payments. However, after a mental health diagnosis for her daughter, Kate realizes the plan with the higher premium would have saved her roughly $1500.00 each year for just her daughter’s treatment
You can download the Fact Sheet here.
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