Mirror mosaic reflecting fractured images of man, car, and mannequin on street

Mental Health Parity

With physical risks dominating the news and our imaginations, it can be easy to forget the equally urgent mental health risks, as Andrew Solomon noted at the outset of the Coronavirus pandemic.

A little-known law requires many insurance plans to give equal treatment to mental health in their coverage.  Under the federal Mental Health Parity and Addiction Equity Act, mental health and addiction treatment must be covered the same as medical treatment.  “Essentially, the Parity Act requires [covered] plans to treat sicknesses of the mind in the same way that they would a broken bone.”[1]  Some states give even more legal protection to mental health treatment.

Years later, insurers do not always follow the law

“It’s disparity, not parity, that’s the norm for mental health status and services in America.” 

Paul Gionfriddo, President and CEO, Mental Health America

A range of insurance practices that used to be standard are now illegal.  For example, insurers generally must:

  • Cover a residential program for mental health or addiction rehab if they would cover medical rehab in a nursing home;
  • Make copayments and pre-approvals as easy for mental health as for other healthcare visits;
  • Pay psychiatrists, psychologists, and other mental health professionals on par with their physical-health colleagues; and
  • Apply accepted rules about what is “medically necessary” that are not stricter for mental than for physical health.

NAMI’s website has more information and resources.

Sustained and Preventive Treatment

As one class action lawsuit established, it is a “generally accepted standard of care” to give sustained and preventive treatment, not just crisis intervention, for mental health, just like for other kinds of healthcare.[2] 

Words of wisdom for all of us, especially in these times.

[1] Gallagher v. Empire HealthChoice Assurance, Inc., 339 F. Supp. 3d 248, 255 (S.D.N.Y. 2018) (quoting Munnelly v. Fordham Univ. Faculty, 316 F. Supp. 3d 714, 728 (S.D.N.Y. 2018)).

[2] Wit v. United Behavioral Health, No. 14-CV-02346-JCS, 2019 WL 1033730, at *28 (N.D. Cal. Mar. 5, 2019).