State laws mandating or regulating mental health benefits
The plan will provide definitions that will help you determine what is covered.Be sure to also check the exclusions section to determine if the treatment you are seeking is specifically excluded.All people in America should have a right to health-care benefits, including needed behavioral health services.The Mental Health America calls on federal and state government to ensure, as a matter of law, that public and private health plans afford people access to needed behavioral health care and treatment on the same basis.For decades, states have set rules for health coverage through mandates, laws that require insurers to cover specific types of medical care or services.The health law contains provisions aimed at curbing this piecemeal approach to coverage.However, as will be outlined in this toolkit, there are still gaps in mental health and substance abuse parity and the principles of the policy statement are still relevant.On a practical note, there are citations in the policy paper that are that continue to be relevant and valuable in making the argument for full parity.
If a mandate increases a plan’s premium, states will be on the hook for the additional premium cost that’s attributable to the mandate.
Since the health law established a comprehensive set of “essential health benefits” that individual and small group plans must cover (unless they existed prior to passage of the law in 2010), it was hoped that mandates would no longer be much in demand, says Sabrina Corlette, project director at Georgetown University’s Center On Health Insurance Reforms.
Mandates are “not the most rational way to build a benefit package,” says Corlette.
You may receive a hard copy or be able to access this document online.
As you review the summary, you will find a section describing any benefits under your plan for mental health conditions and/or drug or alcohol use disorders.