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The Mental Health Parity and Addiction Equity Act

Let’s start at the beginning: 2008. The Mental Health Parity Act is signed into law in 2008; it required insurance groups that offer coverage for mental health issues (or substance use disorders) to provide the same level of benefits that they would for general medical treatment (such as seeing your primary care physician or seeing a specialist).

Dilemma: Insurers and Employers were unsure of who had to provide the benefits (EAP, etc).

The law was supposed to help avoid coverage fights by making sure that the insurance plan would cover mental illnesses in the same way that the insurance plan covers cancer, injuries, etc…

ACA Extension of Parity Requirements

Next: The Affordable Care Act (ACA) extends the reach of MHPAEA’s requirements. Starting in 2014, the ACA will require all small group and individual market plans (plans from private insurance companies) reated before March 23, 2010 to comply with these new federal requirements. These new insurance plans must include coverage for mental health and substance use disorders. This took away the provision dilemma of the MHPAEA (mentioned above).

Mental Health is one of the ten categories of Essential Health Benefits (new with the ACA), and that coverage must comply with the federal parity requirements set forth in MHPAEA.

Meaning: For those wanting to see a mental health professional with your health insurance, you can… (if your policy was created after March 23, 2010). What is significant about March 23, 2010? That was the day the Affordable Care Act was signed into law…

According to Healthcare. gov, The 10 essential categories are:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

Simply put:

People who need mental health care will be on an equal footing with those who require medical care.

Have a question about mental health care and the health care reform? Leave a comment and we will do our best to answer it for you.

If you have been thinking about joining insurance panels, call us at 1-855-4-THRIVE.
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