For Consumers

What mental health and substance use disorder parity means for providers

Federal and state mental health parity laws ensure that health plans treat mental health (MH) and substance use disorders (SUD) the same way they treat medical and surgical care. 

As well, insurance companies cannot use more restrictive methods when they develop and apply provider reimbursement rates. Parity requires equity for: 

Financial requirements

  • Deductibles
  •  Copayments
  • Coinsurance 
  • Out-of-pocket limits

Treatment limits 

  •  Limits on the number of days or visits 
  • Other limits on the scope or duration of treatment 
  •  Prior authorization
  • Medical necessity
  • Step-therapy
  • Reimbursement rates