Mental Health Parity and Health Insurance

A patient hands over an insurance card.
A patient hands over an insurance card. PhotoAlto/Frederic Cirou/Getty Images

Mental health parity is the recognition of mental health conditions as equivalents to physical illnesses.

Historically, many health insurance companies had limited benefits for mental health to a much lower level than those available for physical conditions. Consequently, many people choose not to seek treatment, and brief therapy became the only option for those who choose to get help.

The Mental Health Parity and Addiction Equity Act

Under true mental health parity laws, phobias and other psychological conditions must be treated exactly the same as broken arms or other physical ailments.

The Mental Health Parity and Addiction Equity Act of 2008 made sure that insurers could not discriminate against patients with mental illness, including those with substance abuse problems. MHPAEA requires group health plans and insurance providers cover mental health issues like other illnesses. Specifically, the act ensures that financial requirements and treatments for mental health conditions aren't more restrictive than those for non-mental health illnesses.

The act mandated that mental health and substance abuse coverage be provided at an equivalent level to your medical and surgical benefits. Deductibles, co-pays, and all other out-of-pocket expenses must be equitable to what you pay for medical treatment. In addition, restrictions on the number of visits, the frequency of treatments, and all other services provided must be comparable.

Affordable Care Act

President Barack Obama's Affordable Care Act built upon the Mental Health Parity and Addiction Equity Act of 2008.

Most health plans must now cover preventive services, such as depression screening, for adults and behavioral tests for children at the same cost as other preventative services in an insurance plan. Since 2014, insurance plans can't deny you coverage for "pre-existing conditions."

When shopping for health insurance through the Health Care Marketplace you can choose from a wide variety of health care plans that meet your individual needs. HMOs, PPOs, fee-for-service plans and other options are available through private insurance companies. You can choose a plan with higher deductibles and co-pays but lower premiums, or a higher cost plan with lower per-incident fees. You can visit any doctor you like, including specialists. The specifics will vary according to the plan you choose, but you will not be denied insurance, face higher premiums or be dropped from your plan due to pre-existing conditions, job changes or the onset of illness.

Mental Health Care

Now that the Affordable Care Act supports mental health parity, you will be able to get the mental health care that you need according to your provider's recommendations. Psychiatric medications must be covered by insurance companies' formularies. Of course, the precise benefits and out of pocket expenses will vary according to the plan that you select.

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Article Sources

  • U.S. Department of Labor.