Guide helps Granite Staters understand insurance benefits

  • Riverbend Community Mental Health has purchased 42 Pleasant St., shown here on Thursday, May 30, 2019, as it plans to expand its services in downtown Concord. Caitlin Andrews

Granite State News Collaborative
Published: 4/24/2020 5:08:45 PM
Modified: 4/24/2020 5:08:32 PM

Amid the coronavirus outbreak, there’s been a substantial increase in the number of Granite Staters seeking treatment for mental health conditions like anxiety and depression. At the same time, thousands of people have lost their health coverage after being laid off, leaving many people unsure about where to turn for help.

A new resource guide, available Friday, aims to help those people and others connect with the insurance benefits that they are entitled to. The publication, “2020 Consumer Resource Guide: How to Access Mental Health and Substance Use Disorder Benefits” is available at the websites for New Futures and UNH Law.

It is useful for anyone who needs extra help understanding their insurance coverage, said Lucy Hodder, director of health law and policy programs at the University of New Hampshire’s Franklin Pierce School of Law.

“Getting help is so difficult and it can seem overwhelming,” Hodder said. “During the pandemic it’s even more overwhelming.”

The resource guide was created by the School of Law and New Futures, a nonprofit organization focused on increasing wellness in New Hampshire. Other state organizations and departments, including the New Hampshire Department of Insurance and the Bi-State Primary Care Association contributed to the guide. The guide contains information on enrolling in insurance, finding treatment providers, and appealing denials of coverage, as well as a simple explanation of insurance terms.

“Insurance is complicated,” Hodder said. “Many people are confused or don’t know where to turn.” The resource is designed to be straightforward and easy to read, address some of the most concerns people have about finding treatment and making sure it’s covered by their insurance.

The resource guide was first drafted in 2016. At the time, many people in the state were having trouble getting their insurance providers to pay for mental health and substance abuse treatments, but only a handful had filed complaints with the state, according to Michele Merritt, president and CEO of New Futures.

“We knew there were pervasive problems happening with the health plans, but individuals did not know they had the ability to complain,” Merritt said.

New Futures wanted to empower insurance consumers to know their rights, whether they had a private insurance plan or a Medicaid plan through the state. The guide is meant to help consumers and providers understand what people are entitled to through their insurance coverage, and help them access those services.

For example, few New Hampshire residents realize that the state has a Department of Insurance, dedicated to ensuring that private health insurance companies are following the law. That includes mental health parity – a state and federal law that requires that mental health and substance abuse services be covered in the same way that treatments for physical ailments are.

The department recently found that two New Hampshire providers – Anthem and Harvard Pilgrim – were not adhering to parity laws. The companies are now undergoing two-year compliance action plans in order to bring them to mental health parity.

“We really believe this will enhance access to mental health and substance abuse services in the state,” said Eireann Sibley, communications director for the department.

Between January 2019 and March 2020, 29 complaints were filed with the department, a drastic increase from 2016. However, problems with insurance companies are still likely underreported, said Jake Berry, vice president of policy at New Futures.

“Many people are not aware of the parity law and what is available to them, or the resources that can help them secure the services they’re entitled to,” Berry said.

Sibley urges anyone who is denied for mental health or substance abuse services to appeal the decision.

“We really want to emphasize that patients always have the right to appeal denials,” she said.

Patients who find their private insurance company unresponsive to appeals should contact the Department of Insurance Consumer Hotline at 1-800-852-3416. People with Medicaid can get assistance by calling 1-844-ASK-DHHS.

Consumer complaints and feedback help the department better regulate insurance providers in the state, and ensure that New Hampshire residents have access to care, Sibley said.

“We really welcome all of those calls. The Insurance Department is here to help. The best way for us to understand what’s going on out in the market is for consumers and providers to call us when they’re having issues.”

Anyone who has questions about insurance coverage – whether or not it involves mental health and substance use services – should refer to the guide, Sibley added.

“Any tool that can be provided to help people better understand how to use their insurance is really valuable,” she said. “Health insurance can be hard to navigate and having a resource like this can help people walk through this process.”

These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.



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