Your health plan must cover the following services for mental health and substance abuse disorders:
- Therapy and counseling
- Inpatient, residential and outpatient treatment
- Prescription drugs Your health plan must ensure you receive continuing coverage of prescription drugs for behavioral health conditions without unnecessary treatment disruptions.
- Detoxification from drugs
- Services from licensed behavioral health providers in skilled nursing facilities (for diagnoses your plan covers)
What this means for you
Health insurers must cover services for mental health and substance abuse disorders the same way as they do for medical and surgical services. This is called mental health parity.
- Your health plan’s deductible, copayments, coinsurance and out-of-pocket maximum apply to covered services for mental health and substance abuse disorders.
- Your health plan covers medications for mental health and substance abuse disorders just like other covered prescription drugs.
- Health plans can't refuse to cover mental health and substance use disorder services that are medically necessary.
- Your health plan can’t deny or limit your benefits for mental health and substance abuse disorder services based on your age, condition or because your treatment was interrupted or you didn’t complete it.
- If you have a mental health or substance abuse disorder emergency, your health plan will let you make an appointment for the next day, either in person or through telemedicine.
- If you're a military veteran, you can visit any Veterans Affairs or non-Veterans Affairs facility for free emergency mental health care.
Note: Laws about equal coverage for mental health services don't apply to Original Medicare and Medicare Advantage plans.