Health insurance plans and terms: Searching for the gaps in understanding among families raising children with mental health needs
Study Design: Two samples of children with special health care needs and continuously insured were examined: those with mental health needs and those with autism. Data from the National Survey of Children with Special Health Care Needs 2009-10 were used to examine parent report of adequate insurance (n=20,486/3,702). Pooled data from the Medical Expenditure Panel Survey 2002-11 were used to examine expenditures (n=4,288/346). Types of health insurance included private alone, Medicaid alone, and combined private and wrap-around Medicaid.
Principal Findings: Having Medicaid increased the odds of reporting adequate insurance compared to private alone in both groups (p<0.0001) and Medicaid children had the lowest out-of-pocket costs ($192/$150, p<0.0001). Having combined private and wrap-around Medicaid increased the odds of reporting adequate insurance for children with mental health needs (p<0.05) and, among both groups, these children enjoyed the highest total expenditures ($6447/$11,596, p<0.05) and the highest expenditures paid by their insurance ($5,829/$10,638, p<0.05).
Conclusions: Family plan ratings align with out-of-pocket expenditures but not the breadth and depth of services covered. These findings underscore the growing concern that families may not fully understand health insurance benefits. Strategies need to be developed to educate people about insurance terms and how to pick a plan that best meets their needs.
Learning Areas:Social and behavioral sciences
Describe health insurance plan ratings among parents raising children with mental health needs and with autism and how they vary by type of plan Compare family out-of-pocket and plan paid expenditures for children with mental health needs and with autism and how they vary by type of plan Discuss how family plan ratings align with out-of-pocket expenditures but not the breadth and depth of services covered and implications for how well families understand health insurance benefits for their children with mental health needs and with autism
Keyword(s): Health Insurance, Child/Adolescent Mental Health
Qualified on the content I am responsible for because: I am an epidemiologist and biostatistician with more than twenty years of experience in chronic disease research, with particular focus on evaluating the quality of care and quantitative methods. I am author or co-author of more than 100 articles in peer-reviewed journals and frequently teach at SAS user conferences on the use of SAS software for data management and statistical analyses.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.