The journey to reclaiming control of your life from the clutches of addiction or mental health conditions can be daunting. Accessing that care can also be stressful. As healthcare costs for all services continue to rise, you might be looking for substance abuse treatment programs that are covered by your insurance. The Mental Health Parity and Addiction Equity Act (MHPAEA) helps remove some of the previous barriers to employer-funded insurance plans.1
Don’t let the cost of treatment or the thought of job insecurity keep you from getting the help you need. Call BlueCrest Health Group at 888.340.2214 now.
What Is the Mental Health Parity and Addiction Equity Act?
The MHPAEA is a federal law that prevents group health plans and health insurance issuers offering group or individual health insurance coverage from imposing less favorable benefit limitations on mental health and substance use disorder benefits than on medical or surgical benefits.
In simpler terms, it mandates that insurers cannot place financial requirements or treatment limitations on mental health and substance use disorder benefits that are stricter than those applied to medical or surgical benefits.
Key Components of the MHPAEA
The MHPAEA is packed with provisions aimed at safeguarding your rights as you navigate your path to recovery. Some of its key components include:
- Equity in financial requirements – Insurers cannot set higher deductibles or co-pays for mental health and substance use disorder services than for medical or surgical services.
- Parity in treatment limitations – There should be no stricter limits on the frequency of treatment, number of visits, days of coverage, or other similar limits for mental health or substance use disorder services than for medical or surgical services.
- Same standards for out-of-network services – If a plan offers out-of-network coverage for medical or surgical services, it must offer the same for mental health and substance use disorder services. This means that you cannot be charged higher co-pays or deductibles for seeking treatment from out-of-network providers.
The Mental Health Parity and Addiction Equity Act helps deliver both mental health and substance use disorder treatment coverage on par with other medical conditions, making it easier for individuals to access the care they need.
What’s Not Impacted by the MHPAEA?
The MHPAEA does not apply to individual market coverage. It also exempts small-group health plans that have fewer than 50 employees. States also have the option to expand the definition of a “small employer” to one with 1-100 employees.
The law also does not require health plans to offer mental health or substance use disorder benefits. It only mandates that if these benefits are offered, they must be on an equal footing with medical and surgical benefits.
Seeking Treatment That’s Covered by Your Insurance
Navigating the complexities of insurance coverage and treatment can be overwhelming when you’re struggling with addiction or a mental health condition. To make the most of the protections offered by the MHPAEA, follow these steps:
- Understand your plan – Study your health insurance plan to understand what mental health and substance use disorder services are covered.
- Inquire about compliance – If you’re unsure whether your plan complies with the MHPAEA, ask your insurer, plan administrator, or HR representative.
- Know your rights – If you believe your rights under the MHPAEA have been violated, file a complaint with the appropriate regulatory agency.
- Seek treatment – Don’t let the cost of treatment keep you from seeking help. If your plan is not in compliance, there may still be options available to access affordable care.
At BlueCrest Health Group, we understand that seeking treatment can be intimidating and overwhelming, especially when it comes to navigating insurance coverage. That’s why our team is dedicated to helping you understand your options and access the care you need.
Contact BlueCrest Health Group to Verify Your Insurance Now
Don’t let financial concerns prevent you from getting the treatment and support you need. Our team at BlueCrest Health Group is here to assist you in verifying your insurance coverage and exploring options for affordable care. Contact us online today or at 888.340.2214 to start your journey toward a happier, healthier life. Remember, help is just a call or click away.
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