What are some of the protections under MHPAEA?
What are some of the protections under MHPAEA?
MHPAEA requires that insurers meet mental health parity standards in two areas: quantitative limits and non-quantitative limits.
- Plans must apply comparable financial requirements (such as copay, coinsurance, & deductible) for mental health/substance use disorder and medical surgical care.
- The number of outpatient visits or inpatient days covered must be comparable for mental health/substance use disorder and medical surgical care.
- Prior authorization requirements for mental health/substance use disorder services must be comparable to or less restrictive than those for medical surgical services.
These standards are applied according to classifications of benefits:
- Inpatient / in-network
- Inpatient / out-of-network
- Outpatient / in-network
- Outpatient / out-of-network
- Emergency care
- Prescription drugs