Q&A: Does Mental Health Insurance “Cap” or have a limit per year? Can mental health turn over into Major medical?
Does Mental Health Insurance “Cap” or have a limit per year? Can mental health turn over into Major medical?
I know a woman who is chronically in the psychiatric hospital for suicidality. For those mental health aware—she is more than likely a very low -functioning borderline. Within the last 12 months, she has spent about 17 weeks total on a locked Inpatient unit. Working in mental health myself (though not in insurance) I know the cash-value (so to speak) of an inpatient stay is about $ 1000 per day. Obviously, I am sure the contracted rate is much less… anyway. After being released one week ago, she is voluntarily checking in again this evening. I am sort of shocked she has enough insurance coverage to continuously be re-admitted inpatient. Do the number of days allowed “start over” with each new admission? Either that, or I would have to think that Major Medical kicks in. I am very surprised the insurance continues to cover her, when they are in essence “losing so much money” on this patient—with very little results.
For my own understanding, I would like some insight into this.
Best answer:
Answer by mbrcatz17
Yes, there’s a cap. No, it doens’t convert to major medical.
She might NOT have enough coverage, most policies limit you to 30 days a year, and many have a 30 day LIFETIME limit. My guess is, she’s racking up the bills, and there either isn’t any insurance covering this, or she’s getting a state bed - where the taxpayer is covering this.
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