Parity is about fairness. In healthcare, parity is fundamentally grounded in ensuring mental health and substance use disorder treatment is delivered at the same level, frequency, and availability as other medical care.
Enacted in 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA), also known as the Federal Parity Law, requires insurers to cover illnesses of the brain, such as depression or addiction, no more restrictively than illnesses of other parts of the body, such as diabetes or cancer.
For example, parity laws state that health insurers cannot impose financial restrictions (e.g., co-payments, deductibles, out-of-pocket expenses) or quantitative treatment limitations (e.g., limitations on the number or frequency of visits) on mental health and substance use disorder benefits that are higher or more restrictive than those imposed other medical benefits. Additionally, insurers cannot impose nonquantitative treatment limitations (e.g., prior authorization, medical necessity, step therapy or fail first protocols) on mental health and substance use disorder benefits in a manner that is more stringent than for other medical benefits.
In both 2015 and 2018, The Kennedy Forum Illinois worked with our partners to pass legislation making Illinois’ state parity laws one of the strongest in the nation. Since then, we continue to focus our policy and advocacy work on ensuring that these laws are effectively implemented and appropriately enforced.
Learn More:
- Parity-Frequently Asked Questions
- Understanding Mental Health Parity (Video)
- Parity Track
- Don’t Deny Me – Parity Registry
- Six Step Parity Guide Compliance
- The Health Insurance Appeals Guide: A Consumer Guide for Filing Mental Health and Substance Use Disorder (MH/SUD) Appeals
- How to File a Parity Appeal (Video)
- Fines hold Illinois Insurers accountable for equal coverage of mental health and addiction care (July 17, 2020)
- Mental Health Parity: Ending Discrimination in Insurance Coverage (Video, May 27, 2021)