Mental Health Parity
What is Mental Health Parity?
Mental health parity means that your insurance benefits for mental health or substance use disorders are treated equally to your other health benefits. When an insurance plan has parity, it means, for example, that if you are provided unlimited doctor visits for a chronic condition like diabetes, then they must offer unlimited visits for a mental health condition such as depression or schizophrenia.
Parity requires health plans that cover Mental Health or Substance Use Disorder services to provide the same level of coverage for those services as is provided for physical health care services, with respect to the following:
- Annual and lifetime limits on coverage;
- Financial requirements: deductibles, copayments, coinsurance, out-of-pocket expenses;
- Treatment limitations: limits on the frequency of treatment, number of visits, days of coverage, or other similar limits on the scope or duration of treatment; and
- Availability of coverage for benefits provided by out-of-network providers.
If a patient or provider believes a health plan is violating the law or isn’t administering the health plan according to the contract, they should file a complaint with the North Carolina Department of Insurance or call for consumer assistance at 855-408-1212.
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