Coverage for Mental and Physical Health Must Be Equal

March 26, 2010

Limiting benefits and requiring higher out-of-pocket costs for patients with mental health or substance use disorders is a practice that group health insurance plans must abandon, according to new rules issued by the US government.

Limiting benefits and requiring higher out-of-pocket costs for patients with mental health or substance use disorders is a practice that group health insurance plans must abandon, according to new rules issued by the US government.1

All group health plans that include coverage for mental health or substance use disorders must now cover these conditions as they would any standard medical disorder or surgical procedure in terms of out-of-pocket costs, benefit limits, and practices such as prior authorization and utilization review.

These new rules, which will be implemented under the Mental Health Parity and Addiction Equity Act of 2008, apply to group policies, generally employer-based, that cover 50 or more employees and offer benefits for mental health and substance use disorders. The new parity rules were jointly issued by the Department of Health and Human Services, Department of Labor, and Department of the Treasury and are expected to take effect for plan years beginning on or after July 1, 2010.

References:

References
1. Mincer J. Mental-health benefits. Wall Street Journal. http://online.wsj.com/article/SB126550273725442127.html?mod= WSJ_PersonalFinance_PF4. Published February 7, 2010. Accessed February 16, 2010.