New Resources to Help People Seeking Care to Understand and Access Protections Offered Under the Parity Law for Mental Health and Substance Use Disorder Benefits
In partnership with the Department of Labor, the Department of Health and Human Services (HHS) has developed new, free informational resources that inform Americans of their rights under law on coverage for mental health benefits.
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA or Parity Law) requires most health plans or health insurers that offer coverage for mental health conditions or substance use disorders to make these benefits comparable to those offered for medical and surgical benefits. This means that deductibles, copays, out-of-pocket maximums, and treatment limitations for mental health or substance use disorders must not be more restrictive than corresponding requirements or parameters offered for medical and surgical benefits.
“Since 2008, the Parity Law has required many group health plans and health insurance issuers that provide access to and coverage of mental health conditions and substance use disorders to do so on equal footing with physical health needs, yet many insurance providers continue to fall short in this area,” said HHS Secretary Xavier Becerra. “We must do more to promote the needs and rights of the populations we serve – every person living in America should have access to equal coverage of these life-saving services and supports.”
“The full implementation of parity is essential to ensuring a healthy future for Americans,” said Miriam E. Delphin-Rittmon, Ph.D., the HHS Assistant Secretary for Mental Health and Substance Use and the leader of the Substance Abuse and Mental Health Services Administration (SAMHSA). “It is vital for people to understand that insurance companies covering mental health and substance use conditions must do so as they would other medical conditions, and to understand the steps consumers can take to seek redress if the requirements of the law are not being met.”
“At CMS, we are working across government to improve access to mental health and substance use disorder services and supports for people who rely on our programs for coverage. Access must go hand-in-hand with education as we work to support critical connections to health care coverage,” said CMS Administrator Chiquita Brooks-LaSure. “The key rights already enshrined in law offer a lifeline to coverage and care for communities hard hit by health disparities. At CMS, we are working to educate communities of their rights so they can use their power to access affordable, high-quality, person-centered mental health care.”
“The parity law is a critical component to accessing lifesaving treatment for those with mental health conditions and substance use disorders, and the publications issued today will help ensure that individuals are aware of this important law and its protections,” said U.S. Secretary of Labor Marty Walsh. “As a person in recovery, I know how important it is to have access to those benefits. The Department of Labor has made enforcement of parity laws one of our highest enforcement priorities.”
As the agency charged with reducing the impact of substance use and mental illness on America’s communities, SAMHSA is providing these resources to help inform Americans of their insurance benefits under law and to help state insurance regulators and behavioral health staff better understand parity laws. The following resources have been posted on SAMHSA’s website:
- “Know Your Rights: Parity for Mental Health and Substance Use Disorder Benefits,” an updated trifold pamphlet explaining mental health parity, detailing what it means to the consumer, and listing the protections the parity law provides.
- “Understanding Parity: A Guide to Resources for Families and Caregivers,” which provides an overview of parity geared toward parents, family members or caregivers with information and tools to help them obtain behavioral health services for children or family members in their care.
- “The Essential Aspects of Parity: A Training Tool for Policymakers,” which provides state regulators and behavioral health staff an overview of mental health and substance use disorder parity and how to implement and comply with the federal parity law regarding employee-sponsored health plans and group and individual health insurance.
These updates follow a recent report produced by HHS and the Departments of Labor and Treasury stating that insurance companies are not doing enough to ensure that parity is reflected in the policies they carry.
To find treatment options for mental and substance use disorders, call SAMHSA’s 24/7 National Helpline at 800-662-HELP (4357) or visit findtreatment.samhsa.gov.
Reporters with questions should send inquiries to [email protected].