Benefits Coverage for Therapy:

January 2007 issue

I recently realized that our Benefits for serious therapy cover a maximum of 35 sessions per year, non serious 20. For people who are going weekly, that is 17 weeks not covered by insurance. Why did DePaul decide to limit this?

Response

Source: Jim Friend
Title: Compensation and Benefits Project Manager
Unit/Department: Human Resources
Extension: 2-5293

Response: When asking various members of the university community to provide information, remind them that the answers will be posted on the web as written below. DePaul's mental health benefits under the PPO used to be 20 visits total for outpatient. However, in recent years the University chose to voluntarily follow the Illinois state mandate for fully insured plans for mental health which provides 35 visits for serious mental health treatment. In reality, the DePaul benefit structure is very common. Rarely do employer groups offer unlimited visits or even visits in excess of 35 per year. Many times a member's provider will work to stay within the mental health benefits provided by their benefit plan. Ultimately, cost is always a factor in developing plan designs and to change this particular feature would significantly increase total claim costs and thereby impact the monthly premium for all members, not just members utilizing the services.