The Mental Health Parity Act (officially "The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008") became law on October 3, 2008 and will become effective on January 1, 2010 for most health care plans, providing greater access to care for those with mental health issues. This article will summarize the main benefits of this new law.
The Mental Health Parity Act applies to plans with coverage for fifty or more employees, and will require equity in the treatment of mental health and substance abuse treatments under every plan. This means that health plans can't impose any caps or limitations on mental health or substance abuse treatment that isn't applied to medical and surgical benefits as well. It does not, however, require a plan to offer these benefits. The Mental Health Parity Act also does not mandate coverage of all possible mental disorders recognized by the psychiatric community, it only requires that the dollar amount of coverage be equal. While employers with fewer than 50 employees are exempt from this federal law, they may still be subject to state parity laws. Only state laws that prevent the application of this act will be preempted by it, meaning stronger state parity and other consumer protection laws remain in place.
In general, the following apply under the new law (there are certain exceptions):
Plans can't impose more restrictive annual or lifetime limits on mental health or substance abuse benefits than they do on medical or surgical benefits. This means your health plan can't cap your mental health benefits per year at $5,000 if your medical benefits are capped at $25,000.
Plans can't require more restrictive financial requirements, such as co-payments, deductibles, etc., on treatment for mental health or substance abuse treatment than for medical or surgical benefits. This means that your plan can't require you to pay $50 for a co-payment to see your psychiatrist when your co-payment for a medical specialist, such as a neurologist, is only $30.
The Mental Health Parity Act applies to plans with coverage for fifty or more employees, and will require equity in the treatment of mental health and substance abuse treatments under every plan. This means that health plans can't impose any caps or limitations on mental health or substance abuse treatment that isn't applied to medical and surgical benefits as well. It does not, however, require a plan to offer these benefits. The Mental Health Parity Act also does not mandate coverage of all possible mental disorders recognized by the psychiatric community, it only requires that the dollar amount of coverage be equal. While employers with fewer than 50 employees are exempt from this federal law, they may still be subject to state parity laws. Only state laws that prevent the application of this act will be preempted by it, meaning stronger state parity and other consumer protection laws remain in place.
In general, the following apply under the new law (there are certain exceptions):
Plans can't impose more restrictive annual or lifetime limits on mental health or substance abuse benefits than they do on medical or surgical benefits. This means your health plan can't cap your mental health benefits per year at $5,000 if your medical benefits are capped at $25,000.
Plans can't require more restrictive financial requirements, such as co-payments, deductibles, etc., on treatment for mental health or substance abuse treatment than for medical or surgical benefits. This means that your plan can't require you to pay $50 for a co-payment to see your psychiatrist when your co-payment for a medical specialist, such as a neurologist, is only $30.
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