Mental Health and Substance Use Insurance Help

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

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:

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

Download the Final Report., opens in a new tab

Read the Action Plan for Enhanced Enforcement., opens in a new tab

Resources for States

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

Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed