Group health plans are not required to provide mental health or substance use disorder benefits, but plans that do provide such benefits may not impose financial or treatment limitations that differ from the limitations on medical and surgical benefits under the plan.
The Mental Health Parity and Addiction Equity Act, which was signed in 2008, regulates mental health and substance abuse coverage. This Act has been in effect for several years, but it has largely been unenforced. Last week, a final rule was issued setting forth how the Act will be administered. Now, insurers will have to charge similar copayments and deductibles for mental health and physical health benefits.
This law is separate from the Affordable Care Act, but the Act’s final regulations indicate that compliance is necessary for meeting the essential health benefits requirements of health care reform. The two laws work together to extend much greater coverage and protections to individuals in need of mental health coverage from their health plans.