The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits. MHPAEA supplements prior provisions under the Mental Health Parity Act, which required parity with respect to aggregate lifetime and annual dollar limits for mental health benefits. MHPAEA does not mandate that a plan provide MH/SUD benefits. Rather, if a plan provides medical/surgical and MH/SUD benefits, it must comply with the MHPAEA’s parity provisions. Also, MHPAEA does not apply to issuers who sell health insurance policies to employers with 50 or fewer employees or who sell health insurance policies to individuals.
Web Pages on This Topic
Consumer Information on Health Plans
Provides fact sheets, booklets, and other health plan information from the Department's Employee Benefits Security Administration (EBSA).
Provides publications and other materials to assist employers and employee benefit plan practitioners in understanding and complying with the requirements of the Employee Retirement Income Security Act (ERISA) for the administration of retirement and health plans.
Mental Health and Substance Use Disorder Parity
FAQs, guidance, publications and more on these provisions.
Compliance Assistance Guide: Health Benefits Coverage Under Federal Law
Provides questions and answers and self-compliance tool.