Mental Health Law: Selected Issues: Insurance Parity for Mental Health

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.

Large group health plans cannot impose annual or lifetime dollar limits on mental health benefits that are less favorable than any such limits imposed on medical/surgical benefits.

Essential health benefits under the Affordable Care Act include mental health and substance use disorder services.

MHPAEA did not apply directly to small group health plans, but the Affordable Care Act although its requirements are applied indirectly in connection with the Affordable Care Act's essential benefits provisions do apply to small employers and to the health care exchanges.

CNN 7/25/23

US DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, TREASURY

MentalHealth.gov

National Conference of State Legislatures 12/30/2015

Nami.org

Fact sheet from CMS.gov

Every policy of sickness and accident insurance shall provide benefits for the diagnosis and treatment of biologically based mental illnesses on the same terms and conditions as, and shall provide benefits no less extensive than, those provided under the policy of sickness and accident insurance for the treatment and diagnosis of all other physical diseases and disorders

Health coverage plans must cover biologically based mental illness on parity with other illnesses.

Requiring provision of coverage of treatment of mental or nervous disorders and alcoholism.