MENTAL HEALTH SERVICES
All plans must cover:
Parity protections for Mental Health Services
Marketplace plans must provide certain "parity" protections between mental health and substance abuse benefits on the one hand, and medical and surgical benefits on the other.
This generally means limits applied to mental health and substance abuse services can’t be more restrictive than limits applied to medical and surgical services. The limits covered by parity protections include:
All plans must cover:
- Behavioral health treatment, such as psychotherapy and counseling
- Mental and behavioral health inpatient services
- Substance use disorder (commonly known as substance abuse) treatment
Parity protections for Mental Health Services
Marketplace plans must provide certain "parity" protections between mental health and substance abuse benefits on the one hand, and medical and surgical benefits on the other.
This generally means limits applied to mental health and substance abuse services can’t be more restrictive than limits applied to medical and surgical services. The limits covered by parity protections include:
- Financial — like deductibles, co payments, coinsurance, and out-of-pocket limits
- Treatment — like limits to the number of days or visits covered
- Care management — like being required to get authorization of treatment before getting it
*Since each insurance option differs in cost and benefits, it’s important to discuss your unique needs with an insurance expert who can keep you, your spouse, and your children covered under the right plan at a price you can afford.