How to Make the Most of the Mental Health Parity Act

The Mental Health Parity Act, enacted on January 1, 2009, is a great help to people that have insurance plans that the act applies to and who have mental health and/or substance abuse issues. Mental health has historically taken a back seat to major medical in many health insurance plans, leaving people without adequate coverage to pay for expensive counseling sessions and treatment. The Mental Health Parity Act brings the level of coverage to equal with medical coverage, in plans to which it applies.

The Mental Health Parity Act applies to group insurance coverage from employers of 51+ employees. This means that insurance provided by smaller employers may not offer mental health parity. You should always verify any state laws to make sure the coverage applies in your situation.

Parity is defined as equality. The Mental Health Parity Act was passed to offer insurance coverage for mental health equal to the other medical issues. This is good news for people who suffer from mental health and/or substance abuse problems. Many insurance policies have historically placed limits on mental coverage, so that even with excellent medical coverage the mental health coverage did not keep pace with expenses.

Even with this new policy it is very important to check with your individual insurance policy to determine what your medical and mental health coverage covers. Many insurance policies required pre certification before covering medical of mental health costs. If you do not get procedures pre certified the insurance company may deny benefits.

It is a good idea to contact your insurance provider directly to ask about coverage and requirements. Insurance plans vary, so it is important to get information about your policy, rather than assume you have coverage based on third hand information. Contact the insurance company through their 800 number to ask what your coverage is, whether there are in network providers that offer lower fees through your insurance plan, whether there is prescription drug coverage and whether treatment needs to be pre certified for coverage.

Prescription prices for drugs used for depression and mental illness vary. Your physician may not always keep track of prescription prices, so if he/she prescribes an overly expensive drug, talk frankly with them about prices and ask if there is a less expensive option.

The best way to take advantage of needed mental health coverage is to educate yourself about your policy, so you know what it covers and what documentation is required for treatment. It is important to talk openly with the insurance provider.

Resources:
Mental Health Parity Act

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