Wednesday, July 8, 2015

Know Your Rights: Fair Insurance Coverage for Mental Health

Federal law is clear that health insurance companies cannot discriminate against people seeking care for mental illness or addiction. But how do you know if your insurance company is not complying with the law? What can you do if you suspect a violation?

The American Psychiatric Association (APA) created a tool to help answer these questions. The poster titled, “Fair Insurance Coverage: It’s the Law” (Spanish-language version), clearly and simply explains the law and the steps to take if you suspect a violation.

The poster is intended to help enforce federal law and end discrimination.  Print it out and share the link (

By understanding your rights and taking action you can help ensure fair coverage for yourself and your family, and you can help others by holding insurance companies accountable.

What Federal Law Requires

The Mental Health Parity and Addiction Equity Act requires any group health plan that covers more than 50 employees and offers mental health and/or substance use disorders coverage to provide that coverage with no greater financial requirements (such as co-pays, deductibles, annual or life-time dollar limits) or treatment limitations than the requirements the plan applies to medical / surgical benefits. 

Also, under the Affordable Care Act, new individual and small group plans in and outside of the mandated health insurance exchanges are required to offer mental and substance use disorder coverage similar to medical/surgical benefits.

In addition to federal law, 49 states and D.C. currently have laws relating to insurance coverage for mental health and substance use.  More information, including a summary table of state laws, is available from the National Conference of State Legislators.

By Deborah Cohen, senior writer, American Psychiatric Association

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