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The Mental Health Parity Act of 2008: Supporting Your Access to Affordable Counseling

The Mental Health Parity Act of 2008: Supporting Your Access to Affordable Counseling

For those who do have medical insurance, access to affordable mental health and substance abuse counseling is less of a hurdle than it used to be. That’s due in large part to the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. This law was one of the biggest milestones in pushing insurance providers to treat mental illness and substance abuse disorders with the same consideration as they do physical illness. But what exactly does the act do? Here, we’ll explore the specific things this act accomplishes and what you can do if you feel like your insurance company is in violation of this law.

“Parity” Doesn’t Mean Guarantee

One of the myths about the Mental Health Parity Act is that it requires health insurance providers to cover mental health care. Unfortunately, this isn’t in the case. Instead, the Parity Act requires those insurers who do offer mental health care coverage to provide these benefits in the same manner and at the same level as they do physical health coverage. This means that health insurance providers cannot do the following for mental health conditions:

  • Require higher percent co-pays for mental health versus physical health services
  • Lower the number of approved inpatient or residential treatment days
  • Disallow the use of care management tools and resources for mental health care
  • Apply different methods or higher requirements for meeting medical necessity

However, because “parity” isn’t the same as “required to cover,” health insurance providers are still not required to offer mental health coverage, nor are they required to cover specific mental health conditions. The law only requires that if they do offer this coverage, it must be on the same level as what they offer for physical health coverage.

What if My Insurance Company Isn’t Following the Law?

There are a few things to keep in mind if you think your insurance company is violating the Mental Health Parity Act:

  • Is it an issue of denying coverage or requiring additional things because the condition is a mental health diagnosis? Remember that insurance isn’t required to cover specific conditions.
  • Is your insurance required to comply with the law or is it exempted? Common exemptions are for small employer plans created prior to 2010, church or self-employment plans run by local or state governments, or plans that have been approved for exemption.

If you feel that the issue is one of parity and that the plan falls under the requirements of this law, contact the Department of Health and Human Services for guidance on reporting the issue. Depending on your plan, they may be able to field this complaint directly, or will direct you to the appropriate federal or state agency that holds oversight. Remember to keep notes and any documentation supporting your concern.



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Jennifer N.
Posted on 10/30/2017 by Jennifer N.

Jennifer is a writer for OpenCounseling. She has worked at a number of state and non-profit organizations, providing counseling, training, and policy development


 

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