Understanding New Rules That Widen Mental Health Coverage

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The president’s signature Affordable Care Act includes mental health care andsubstance abuse treatment among its 10 “essential” benefits, which means plans sold on the public health care exchanges must include coverage.

In addition, rules to fully carry out an older law — the Mental Health Parity and Addiction Equity Act of 2008 — were issued in November, after a long delay. The parity law says that when health insurance plans provide coverage for mental ailments, it must be comparable to coverage for physical ailments. For instance, plans cannot set higher deductibles or charge higher co-payments for mental health visits than for medical visits, and cannot set more restrictive limits on the number of visits allowed.

The new parity rules apply to most health plans and are effective beginning July 1, although many plans will not have to comply until January of next year.