• ISSUES SPOTLIGHT: Mental Health Parity

Starting today, there's a good chance that your health insurance plan will offer better coverage for mental health services.

As part of the Mental Health Parity and Addiction Equity Act of 2008, most private sector health plans will be required to provide insurance coverage for mental and addictive disorder services with the same terms as other types of care. In other words, terms such as “reimbursements,” “number of visits,” “annual and lifetime caps,” and “copayments” for counseling, medications, and related mental health services must be the same as treatment for a physical condition or illness. Many insurance policies used to place arbitrary limits on the number of counseling sessions that individuals could obtain, but in 2010 they will no longer be able to do that.

There are limitations to the legislation. It only applies to group plans of companies employing 50 or more people. Consequently, it does not apply to Medicare or Medicaid. There is also no requirement that insurance companies provide mental and addictive disorder treatment. They are only required to provide it at the same level if they do provide it.

While 42 states have had mental health parity requirements of some form, the Federal legislation supersedes laws with weaker requirements. The District of Columbia, Maryland, and Virginia are among the states that legislated some level of mental health parity. Since the state parity laws are different and complex, it's a good idea to check with your insurance company or human resources department to see if your coverage will increase in 2010. Your PC&CC counselor is also available to help you navigate the complex system.

Comments

[James Morgan - Puritan Financial Advisor]

There is also no requirement that insurance companies provide mental and addictive disorder treatment. They are only required to provide it at the same level if they do provide it.