While health insurance policies may cover hospital costs for treatment of "physical disorders," many exclude or severely limit coverage for psychiatric treatment. Some states require insurance carriers to provide the same coverage and benefits for severe psychiatric disorders that they provide for any other illness. These laws are called "parity laws." The American Academy of Child & Adolescent Psychiatry maintains a listing of parity laws by state.

Some judges have ruled that bipolar disorder constitutes a physical disability and must be covered the same as other disabilities.Children can be insured separately from their parents when a family is unable to afford private family insurance. The United States Department of Health and Human Services has information on this program at http://www.insurekidsnow.gov/. If you have a low income, your child may qualify for Supplemental Security Income and Medicaid.

A diagnosis of bipolar disorder may affect a child's ability to obtain individual (non-group) medical insurance in the future. Federal law prohibits an insurance company from denying coverage under a group plan due to a pre-existing condition if the person can establish that he or she has been continually insured for at least two years before applying for the new policy. Some states have protections for people with pre-existing medical conditions. For more information on your state laws, visit www.insure.com/health/lawtool.cfm.

Even with private insurance, the insurance company may refuse to pay for expensive services such as hospitalization. The insurance company may take the position that hospitalization is not necessary, or its guidelines may require the hospital to release patients before they have stabilized.

Some families that appeal denials of coverage manage to get the necessary services covered even though the language of the plan excludes them. Payment of claims is often discretionary and an insurance company, or an employer who is self-insured, may choose to extend coverage once they learn the facts and hardships the family is facing. A Consumer Guide to Handling Disputes with Your Private or Employer Health Plan can be found atwww.kff.org/consumerguide. A listing of each state's external review process for appealing denials of service by insurance companies or managed care plans is at: www.kff.org/consumerguide/states.html.

If you are having severe difficulties, consult an attorney for information on whether the insurance company has violated the laws of your state, or has breached your insurance contract.

Some families must have their child hospitalized on an involuntary or court-ordered basis in order to require the insurance company to pay. Similarly, families whose children are discharged from the hospital before they have stabilized may have no choice but to allow the child to be released until the next obvious dangerous act on the part of the child — and then proceeding with involuntary commitment. If you have an older teenager, you may wish to consult an attorney to institute guardianship proceedings that will allow you, rather than the child, to decide whether hospitalization is necessary.

A child who is a danger to others should qualify for a 72-hour evaluation for an involuntary hold, which can be extended if necessary.

Many hospitals are designated as 72-hour detention facilities and can initiate a "hold" order themselves. Otherwise, a police officer can initiate the hold proceeding and take the child to a designated facility for mental health treatment. It may be necessary to take your child out of the hospital to stay with someone else temporarily until the child threatens self-harm or injury to others, and then call the police.

Other ways you may be able to get help include contacting your County Mental Health agency or requesting a judge to issue an order telling a residential treatment center to give your child the next available bed.

Disclaimer

Families with legal problems are urged to hire a capable local attorney licensed to practice in the state in which the family resides. The Balanced Mind Foundation (The Balanced Mind Foundation) is unable to provide you with legal advice and The Balanced Mind Foundation’s attorneys are unable to represent you.

The information on this web page is not a substitute for legal advice. It is intended to be general in nature. The laws of each state are different. The law is always changing. The information here may not reflect the latest legal developments. NO WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, IS GIVEN AS TO THE ACCURACY OF THIS INFORMATION.