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Insurance Companies Now Must Cover Mental Health Benefits at Parity with Medical Benefits

Summary: 
Insurance companies must cover mental health and addiction benefits at parity with medical and surgical benefits.

Today, as part of the President and Vice President’s continuing efforts to increase access to mental health services, the Administration issued the final rule implementing the Mental Health Parity and Addiction Equity Act of 2008.

Today’s action means that for group and individual market health plans, insurance companies must cover mental health and addiction benefits at parity with medical and surgical benefits. In January, the Department of Health and Human Services also released a letter to State health officials clarifying that Medicaid plans must also comply with parity requirements.

Parity is not just a buzzword. It has a real impact for the millions of people who are experiencing or will experience mental illness or addiction. In fact, parity works to break down two key barriers that too often prevent these individuals – our friends, our family, our neighbors – from seeking help. First, it breaks down the financial barrier by generally prohibiting health plans from placing more restrictive monetary requirements (for example, co-pays) or treatment limitations (for example, covered visits)  on mental health and substance abuse benefits than on comparable medical and surgical benefits.  Second, parity reduces the stigma associated with mental illness and addiction by reaffirming that illnesses of the brain should not be treated differently than illnesses of the body.

Today’s rule gives consumers new tools that will increase parity. For example, the rule ensures that parity applies to services such as residential or intensive outpatient treatment. It also clarifies the transparency requirements insurance companies must follow, so consumers can be equipped with the information they need to make sure their plans are complying with the law.

In January, as part of their comprehensive plan to reduce gun violence, the President and Vice President committed to issuing this final rule by the end of the calendar year. After accomplishing this step today, the Administration has now completed or made significant progress on all 23 executive actions included in their plan. You can read more about these executive actions in the White House’s updated progress report.