Content created by Assistant Secretary for Public Affairs (ASPA)
For too long, insurance coverage was overly complex, hard to access, and discriminatory towards individuals with mental and substance use conditions. There was no recognition that mental health and substance use disorders are every bit as important as physical health, and that going without effective treatment can be debilitating and even life threatening.
Health plans and insurers that offer mental health and substance use disorder benefits must provide those benefits comparable to their coverage for general medical and surgical care. But, parity is only meaningful if health plans are implementing it well, consumers and providers understand how it works, and there is appropriate oversight.
Understand Your Rights and Policy Updates
- The Consumer Guide to Disclosure Rights helps you understand what information to request to help determine which mental health or substance use disorder benefits will be paid for by your health plan, what information your plan relies on to approve or deny benefits, and what information is available to help you determine if your plan’s mental health and substance use disorder benefits are offered at parity.
- The Know Your Rights: Parity for Mental Health and Substance Use Disorder Benefits brochure lists some of the common limits placed on mental health and substance use disorder benefits and services and includes additional information on parity.
- The Center for Consumer Information and Insurance Oversight summarizes the Mental Health Parity and Addiction Equity Act (MHPAEA) and highlights the key changes from previous policy.
If you or a family member have been denied a health benefit in error, you may be protected by parity laws. Contact your State Insurance Commissioner’s office for details about how to file a consumer complaint.
Find out how to file a consumer complaint by selecting your state's office below:
- Alabama Department of Insurance
- Alaska Department of Commerce, Community, and Economic Development, Division of Insurance
- Arizona Department of Insurance and Financial Institutions
- Arkansas Insurance Department
- American Samoa Office of the Insurance Commissioner
- California Department of Insurance
- Colorado Department of Regulatory Agencies, Division of Insurance
- Connecticut Insurance Department
- Delaware Department of Insurance
- District of Columbia Department of Insurance, Securities & Banking
- Florida Chief Financial Officer, Division of Consumer Services
- Georgia Office of Commissioner of Insurance and Safety Fire
- Guam Office of the Attorney General
- Hawaii Department of Commerce and Consumer Affairs
- Idaho Department of Insurance
- Illinois Department of Insurance
- Indiana Department of Insurance
- Iowa Insurance Division
- Kansas Insurance Department
- Kentucky Department of Insurance
- Louisiana Department of Insurance
- Maine Professional and Financial Regulation, Consumer Healthcare Division
- Maryland Insurance Administration
- Massachusetts Division of Insurance
- Michigan Department of Insurance and Financial Services, Office of Consumer Services
- Minnesota Department of Commerce
- Mississippi Insurance Department
- Missouri Department of Insurance
- Montana Commissioner of Securities and Insurance
- Nebraska Department of Insurance
- Nevada Department of Business and Industry, Division of Insurance
- New Hampshire Insurance Department
- New Jersey Department of Banking & Insurance
- New Mexico Office of the Superintendent of Insurance
- New York Department of Financial Services
- North Carolina Department of Insurance
- North Dakota Insurance Department
- Northern Mariana Islands
- Ohio Department of Insurance
- Oklahoma Insurance Department
- Oregon Division of Financial Regulation
- Pennsylvania Insurance Department
- Puerto Rico
- Rhode Island Office of the Health Insurance Commissioner
- South Carolina Department of Insurance
- South Dakota Department of Labor & Regulation, Division of Insurance
- Tennessee Department of Commerce & Insurance
- Texas Department of Insurance
- Utah Insurance Department
- Vermont Department of Financial Regulation
- Virginia State Corporation Commission
- Virgin Islands
- Washington Office of the Insurance Commissioner
- West Virginia Office of the Insurance Commissioner
- Wisconsin Office of the Commissioner of Insurance
- Wyoming Department of Insurance
Behavioral Health Treatment Services Locator
A confidential and anonymous source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance use/addiction and/or mental health problems.
Substance Use Treatment Locator
Millions of Americans have a substance use disorder. Help is available, treatment works and people recover every day. Find a state-licensed treatment facility near you.
Parity Policy and Implementation
The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires health insurers and group health plans that offer mental health and substance use disorder benefits to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical/surgical care. MHPAEA was expanded to ensure that qualified plans offered on the Health Insurance Marketplace® cover many behavioral health treatments and services.
A Task Force of key Federal agencies was convened to focus on ensuring that Americans receive the coverage and treatment that they need. The Task Force published a report that offered recommendations on how to:
- Support consumers
- Improve parity implementation
- Enhance parity compliance and enforcement
Read the Action Plan for Enhanced Enforcement.
Resources for States
- Medicaid.gov summarizes the parity requirements for Medicaid and CHIP programs regarding behavioral health services.
- Approaches in Implementing the Mental Health Parity and Addiction Equity Act offers best practices for States to implement parity and tools for understanding and monitoring compliance.
Federal Actions to Achieve Parity in Health Coverage
Key legislation to achieve parity in the provision of health insurance coverage for behavioral health care and general medical and surgical care:
- 21st Century Cures Act of 2016
- Patient Protection and Affordable Care Act (ACA) of 2010
- Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008
Timeline of Federal Health Insurance Parity Policies
1961
President Kennedy directs the Civil Service Commission (now known as the Office of Personnel Management) to implement parity (by 1975 this was scaled back)
1970s through present day
Parity laws enacted in many states - mostly for small group health plans; some for individual policies; many states establish minimum benefit level requirements for mental health and substance use disorders - employer-sponsored group health plans are generally exempt
1992
The first federal parity legislation is introduced in Congress by Senators Pete Domenici and John Danforth (S.2696)
1996
The Mental Health Parity Act enacted requiring comparable annual and lifetime dollar limits on mental health and medical coverage in large group health plans including employer-sponsored group health plans
1999
President Clinton directs the Office of Personnel Management to implement parity in the Federal Employee Health Benefit Plan (FEHBP)
2003
President Bush's New Freedom Commission on Mental Health includes a recommendation regarding parity in the Commission's Final Report
2008
Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) is signed into law - applying to large group health plans including employer-sponsored plans, effective for most plans starting in 2010
Medicare Improvements for Patients and Providers Act enacted including a provision to phase out statutory provision requiring a higher co-pay for outpatient mental health services
2009
Children's Health Insurance Program Reauthorization Act enacted requiring parity in CHIP plans
CMS releases State Health Official letter to provide additional guidance regarding MHPAEA's application to CHIP
2010
The Affordable Care Act (ACA) enacted and extends parity protections to individual health insurance policies and Medicaid expansions to low-income childless adults
Interim final rules issued to implement MHPAEA effective for most policies and plans in 2011
2013
Final rules are issued to implement MHPAEA - effective for most policies and plans in 2015
Final rules on Essential Health Benefits are issued, implementing mental health and substance use disorder as a category of EHB and extending MHPAEA final rule parity requirements to small group insurance and individual insurance plans starting in 2015
Final rules on Alternative Benefit Plans are issues providing further guidance regarding MHPAEA's application to Essential Health Benefits in this Medicaid program
Medicaid State Health Officials letter published providing guidance on the application of MHPAEA requirements to Medicaid managed care organizations, Medicaid Alternative Benefit Plans, and the Children's Health Insurance Program
2016
TRICARE issues a proposed rule that levels cost sharing between medical-surgical and behavioral health care and eliminates treatment limits for mental health and substance use disorder care
Final regulations issued on parity in Medicaid managed care organizations, Medicaid Alternative Benefit Plans, and the Children's Health Insurance Program