Can a policy or plan of health coverage require that services for mental health conditions be pre-authorized?
Yes. A plan may require pre-authorization for particular services for the treatment of mental health conditions if the pre-authorization requirement is no more restrictive than the predominant pre-authorization limitations applied to substantially all services to treat physical illness. Q: If every group sickness and accident insurance policy in Ohio is required to provide coverage for biologically-based mental illness, does this mean that the $550 outpatient benefit mandate for mental or emotional disorders is also triggered? A: Yes. Pursuant to Section 3923.28 of the Revised Code, every group policy that provides some form of coverage for mental or emotional disorders shall provide at least $550 of outpatient benefits for mental or emotional disorders for each eligible person, even if the mental or emotional disorder is not defined as a biologically-based mental illness. Please note that Section 3923.28(F) of the Revised Code provides that the $550 of outpatient benefits for mental o
