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Coverage for Mental Health Conditions

Some health plans treat individuals who have mental health disorders differently. Coverage for mental health conditions in the U.S. has traditionally not been on par with coverage for medical or surgical conditions. For this reason, the Mental Health Parity law was passed in 1996. This law provided parity, but only for annual and lifetime limits between mental health coverage and medical surgical coverage. The current version of this law is looking to expand parity by including deductibles, co-payments, out-of-pocket expenses, coinsurance, covered hospital days, and covered out-patient visits. While this law, when it is passed, is likely to increase mental health coverage even more, legislatures will probably need to continue working to amend and clarify provisions of the act for years to come. The Joint Committee of the Senate and House of Representatives continues to work to eliminate this bias. Former First Lady Rosalynn Carter is a proponent of this legislation and works tirelessly with the committee to promote it. You should check your plan’s policy to determine whether you have any limitations on coverage for mental health conditions.

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Ruthann Russo, PhD, JD, MPH, RHIT, is a healthcare expert with more than 20 years of experience working in and advising healthcare organizations.

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