Do you have a mental health or substance use disorder?
Are you interested in seeking professional care, but unsure if your insurance policy will allow you to get the help you need?
If you find yourself in this position, you are in the same group as millions of others. Fortunately, recent changes will go a long way in allowing you to get the treatment you need in the near future.
Mental Health Parity and Addiction Equity Act (MHPAEA)
The primary goal of the Mental Health Parity and Addiction Equity Act (MHPAEA) is simple: to make it easy for Americans to receive the care they need by prohibiting discriminatory practices by insurance companies that could limit behavioral health treatment.
How does it Work?
On the surface, this sounds perfect for millions of people. However, you have to learn more about how the Mental Health Parity and Addiction Equity Act will work before you know how to move forward.
With this law in place, many insurance policies will have to cover mental health and substance use disorders in the same manner as traditional medical and surgical treatment. This will apply to the following areas:
- Out of pocket maximums, coinsurance, and copays
- Care management tools
- Limitations on services, such as the number of inpatient days that are covered by the policy
- Coverage for seeking care from an out-of-network provider
There are still limitations
With all this in mind, it is important to note that the Mental Health Parity and Addiction Equity Act does not require the following:
- Insurance plans are not required to provide coverage for specific treatment
- Insurance plans are not required to provide coverage for mental illnesses or substance use disorders in general
With these points taken into consideration, insurance policies that do offer mental and substance abuse treatment must be provided at the same level as medical health conditions.
Does all this sound confusing?
If so, take the time to contact your health insurance provider to discuss what your policy offers. Along with this, you can always contact a rehab facility that can verify your insurance and answer any questions about your coverage as it relates to the treatment you are seeking.
Learn more about the Federal Parity Laws at https://beta.samhsa.gov/health-reform/parity