{"id":355849,"date":"2016-04-04T10:46:17","date_gmt":"2016-04-04T15:46:17","guid":{"rendered":"https:\/\/ability-fl-prod.internetbrands.com\/ability-law\/healthcare\/patient-rights\/what-is-the-mental-health-parity-act.html"},"modified":"2026-08-19T16:45:00","modified_gmt":"2026-08-19T21:45:00","slug":"what-is-the-mental-health-parity-act","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/what-is-the-mental-health-parity-act.html","title":{"rendered":"What Is the Mental Health Parity and Addiction Equity Act?"},"content":{"rendered":"\n<div class=\"wp-container-core-columns-is-layout-9d6595d7 fl-sectionWithSidebar fl-container fl-flex fl-flex-wrap fl-gap30\">\n<div class=\"fl-page-articles fl-section-main fl-section-main-full-width\"><h1 class=\"fl-no-margin-top\">What Is the Mental Health Parity and Addiction Equity Act?<\/h1>\n\n<section class=\"fl-gutenberg-byline\">\n    <div class=\"fl-gutenberg-byline-content\">\n                    By <a href=\"https:\/\/www.findlaw.com\/company\/our-team\/melissa-mccall-j-d\/\">Melissa McCall, J.D.<\/a> | Legally reviewed by <a\n                href=\"https:\/\/www.findlaw.com\/company\/our-team\/susan-richmond-esq\/\">Susan Mills Richmond, Esq.<\/a>\n                | Last updated\n        <time>\n                            August 19, 2026\n                    <\/time>\n    <\/div>\n\n    \n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-legally-reviewed\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Legally Reviewed\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>This article has been written and reviewed for legal accuracy, clarity, and style by <a href=\"https:\/\/www.findlaw.com\/company\/our-team.html\">FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with <a href=\"https:\/\/www.findlaw.com\/company\/company-history\/editorial-policy.html\">our editorial standards<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n\n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-fast-checked\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Fact-Checked\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>The last updated date refers to the last time this article was reviewed by FindLaw or one of our <a href=\"https:\/\/www.findlaw.com\/company\/our-team\/contributing-authors.html\">contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please <a href=\"https:\/\/lawyers.findlaw.com\/?fli=bylinelink\" target=\"_blank\" rel=\"noopener\">contact an attorney in your area<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n<\/section>\n\n\n<div class=\"fl-key-takeaways fl-mb30\" data-testid=\"fl-key-takeaways\">\n    <div class=\"fl-card-content\">\n        <div class=\"fl-card-body fl-card-bg-teal fl-flex fl-flex-column\">\n                            <h2 class=\"fl-card-title fl-h2 fl-no-margin\">Key Takeaways<\/h2>\n                        <div data-testid=\"ai-message-body\">\n<div>\n<div id=\"Bss9fZTj4DQZC2KGD1SM1-content-0\">\n<p>The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health insurers to provide mental health and substance use disorder benefits on equal terms with medical and surgical care. Plans can\u2019t impose stricter limits, higher costs, or more restrictive rules on behavioral health treatment than they do on physical health services.<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n        <\/div>\n    <\/div>\n<\/div>\n\n\n<p>Mental health is a critical aspect of your overall health. It shouldn&#8217;t be treated differently than physical health, although many view it as such.<\/p>\n<p>Congress passed the <a href=\"https:\/\/www.cms.gov\/marketplace\/private-health-insurance\/mental-health-parity-addiction-equity\" target=\"_blank\" rel=\"noopener\">Mental Health Parity and Addiction Equity Act<\/a> (MHPAEA) in 2009. This federal parity (equality) law ensures that insurers offering mental health coverage treat mental health coverage the same way they treat physical health coverage. Under the MHPAEA, health insurers must provide equal benefits for mental health and physical health conditions and providers.<\/p>\n<p>This article outlines coverage for mental health and substance use disorder services. If your plan isn\u2019t meeting parity requirements, a <a href=\"https:\/\/lawyers.findlaw.com\/health-health-care-law\/\" target=\"_blank\" rel=\"noopener\">healthcare attorney near you<\/a> can explain your rights and pursue corrective action.<\/p>\n<h2>Mental Health Coverage in the U.S.<\/h2>\n<p>Millions of Americans struggle every year with mental illness and substance use disorder. The\u00a0<a href=\"https:\/\/www.nami.org\/home\" target=\"_blank\" rel=\"noopener\">National Alliance on Mental Illness<\/a>\u00a0(NAMI) is a mental health advocacy organization. According to NAMI, the following groups experience some form of mental illness each year:<\/p>\n<ul>\n<li>American adults \u2013 23%<\/li>\n<li>American youth \u2013 16%<\/li>\n<\/ul>\n<p>Mental health practitioners provide mental health services to help this population manage their illness. Coverage of <a href=\"https:\/\/www.webmd.com\/mental-health\/default.htm\" target=\"_blank\" rel=\"noopener\">mental health and substance use disorders<\/a> includes both inpatient and outpatient treatment options.<\/p>\n<h3>Mental Health Conditions<\/h3>\n<p>The phrase &#8216;mental health conditions&#8217; is broad. It includes, but is not limited to, the following:<\/p>\n<ul>\n<li>Depression<\/li>\n<li>Anxiety disorders<\/li>\n<li>Substance abuse<\/li>\n<li>Personality disorders<\/li>\n<li>Anorexia and bulimia<\/li>\n<li>Schizophrenia<\/li>\n<li>Bipolar disorders<\/li>\n<\/ul>\n<h2>Mental Health and Insurance<\/h2>\n<p>Before the MHPAEA, health plans offered different benefits for mentally ill patients compared to physical conditions. Insurers often imposed less favorable benefit limitations on behavioral health than medical health. For example, a plan might have different co-pays for mental health care than medical care.<\/p>\n<p>The MHPAEA\u00a0<a href=\"https:\/\/www.cms.gov\/marketplace\/private-health-insurance\/mental-health-parity-addiction-equity#Introduction\" target=\"_blank\" rel=\"noopener\">originally applied<\/a>\u00a0to group health plans and group health insurance coverage. This changed after the passage of the\u00a0<a href=\"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/obamacare-basics-understanding-the-affordable-care-act.html#:~:text=The%20Affordable%20Care%20Act%20is,of%20the%20health%20insurance%20industry.\">Affordable Care Act<\/a>\u00a0(ACA). The ACA amended the MHPAEA to include individual health insurance coverage.<\/p>\n<h2>MHPAEA Requirements<\/h2>\n<p>The MHPAEA requires mental health and substance abuse coverage to be at <a href=\"https:\/\/www.samhsa.gov\/newsroom\/press-announcements\/20220427\/hhs-new-mental-health-substance-use-disorder-benefit-resources#:~:text=The%20Mental%20Health%20Parity%20and,for%20medical%20and%20surgical%20benefits.\" target=\"_blank\" rel=\"noopener\">parity with medical and surgical coverage<\/a>. In other words, a qualified insurance plan can&#8217;t make mental health and substance abuse coverage more complex and more expensive than medical coverage.<\/p>\n<p>&#8220;Parity&#8221; means that elements of insurance coverage are fundamentally comparable. For example, a plan wouldn&#8217;t meet parity requirements if the length of inpatient visits covered is shorter for mental health treatment than for medical treatment.<\/p>\n<hr \/>\n<p>If you believe your insurer has violated your rights under the MHPAEA, an attorney can guide you through the steps to protect your access to mental health care. <a href=\"https:\/\/lawyers.findlaw.com\/health-health-care-law\/\" target=\"_blank\" rel=\"noopener\">Find local legal help<\/a>.<\/p>\n<hr \/>\n<h3>Elements of Insurance Coverage<\/h3>\n<p>The MHPAEA\u00a0distinguishes between <a href=\"https:\/\/www.cms.gov\/marketplace\/private-health-insurance\/mental-health-parity-addiction-equity\" target=\"_blank\" rel=\"noopener\">quantitative and non-quantitative treatment limitations<\/a>. Quantitative treatment limitations look at numbers and include things like number of visits. Non-quantitative treatment limitations include items such as prior authorizations.<\/p>\n<p>Qualified insurance plans must guarantee that coverage is at parity for the following:<\/p>\n<ul>\n<li>Co-pays<\/li>\n<li>Coinsurance<\/li>\n<li>Cost-sharing<\/li>\n<li>Deductibles<\/li>\n<li>Reimbursements<\/li>\n<li>Numerical treatment limitations<\/li>\n<li>Out-of-pocket maximums<\/li>\n<li>Inpatient and outpatient visit limits<\/li>\n<li>Prior authorization<\/li>\n<li>Out-of-network coverage<\/li>\n<\/ul>\n<p>Medical necessity criteria (used to determine whether insurance will pay for treatment)<\/p>\n<h2>MHPAEA Parity Requirement Exemptions<\/h2>\n<p>The\u00a0<a href=\"https:\/\/www.hhs.gov\/healthcare\/about-the-aca\/index.html\" target=\"_blank\" rel=\"noopener\">Affordable Care Act<\/a> (ACA) affected many aspects of the MHPAEA by extending parity requirements to more plans. Before the implementation of the ACA, small employer plans weren&#8217;t subject to the MHPAEA. Also, parity requirements didn&#8217;t apply to plans without mental health coverage.<\/p>\n<p>Today, insurance plans can&#8217;t omit mental health coverage\u2014it is an essential health benefit. <a href=\"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/obamacare-small-business-compliance-with-the-affordable-care-act.html\">Non-exempt insurance plans<\/a> must include mental health care and substance use disorder benefits. Such plans must also meet parity requirements.<\/p>\n<h3>Exempt Health Insurance Plans<\/h3>\n<p>MHPAEA requirements don&#8217;t apply to the following <a href=\"https:\/\/www.findlaw.com\/consumer\/insurance\/health-insurance.html\">health insurance<\/a> plans:<\/p>\n<ul>\n<li>Retiree plans<\/li>\n<li>Medicare<\/li>\n<li>Some\u00a0Medicaid\u00a0plans<\/li>\n<li>Government-sponsored self-insured plans<\/li>\n<li>Small group insurance plans<\/li>\n<li>Small employer plans created before March 23, 2010<\/li>\n<\/ul>\n<h2>State Mental Health Parity Laws<\/h2>\n<p>The MHPAEA is a federal parity law. State parity laws are often stricter about enforcing parity. For example,\u00a0<a href=\"https:\/\/ag.ny.gov\/sites\/default\/files\/mental_health_parity_brochure.pdf\" target=\"_blank\" rel=\"noopener\">New York<\/a>\u00a0has one of the more stringent parity laws among the states. New York State requires a minimum of 30 days of inpatient and 20 days of outpatient treatment for mental health. The law also defines those illnesses that health insurance companies must fully cover.<\/p>\n<p>Defining illnesses eliminates reliance on <a href=\"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/medical-necessity-and-the-law.html\">medical necessity<\/a> criteria to avoid paying for mental health coverage.<\/p>\n<h2>Insurance Coverage Concern? Get Legal Help<\/h2>\n<p>If your health insurance plan doesn&#8217;t offer comparable mental health and substance use disorder treatments, consider consulting an attorney to learn your rights and options. A healthcare lawyer can help you understand applicable federal and state laws concerning mental health parity and advise on next steps to get the benefits you&#8217;re entitled to.<\/p>\n<p class=\"\">FindLaw\u2019s\u00a0directory of\u00a0<a href=\"https:\/\/lawyers.findlaw.com\/health-health-care-law\/\" target=\"_blank\" rel=\"noopener\">healthcare attorneys<\/a> can get you started. Enter your city or ZIP code for a list of qualified legal professionals near you. Because some of your state\u2019s laws are relevant, your attorney should be licensed in your state. Your search results will also show important details about prospective attorneys, like ratings and whether they offer free case evaluations.\u00a0<\/p>\n\n\n<div class=\"was-this-helpful\">\n    <div\n            class=\"was-this-helpful__question-container\"\n            aria-labelledby=\"was-this-helpful__question\"\n            role=\"group\"\n    >\n        <span\n                id=\"was-this-helpful__question\"\n                class=\"was-this-helpful__question fl-text-lg-bold\"\n        >Was this helpful?<\/span>\n        <button\n                class=\"was-this-helpful__button fl-text-sm\"\n                aria-label=\"Yes\"\n                value=\"yes\"\n        >\n            <span class=\"was-this-helpful__button-text fl-text-bold\">Yes<\/span>\n            <i class=\"was-this-helpful__button-icon\">\n                <svg width=\"22\" height=\"22\" viewBox=\"0 0 22 22\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <g id=\"thumbs-up\" 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                 for=\"was-this-helpful__radio-button--missing-info\"\n                        >Missing the information I need<\/label>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--complicated\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Too complicated\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--complicated\"\n                        >Too complicated \/ too many steps<\/label>\n                    <\/div>\n                    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          class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Other\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--negative-other\"\n                        >Other<\/label>\n                    <\/div>\n                <\/fieldset>\n            <\/div>\n            <div class=\"was-this-helpful__form-buttons-container\">\n                <button\n                    class=\"was-this-helpful__feedback-button was-this-helpful__feedback-button--positive at-feedback-submit fl-button secondary\"\n                    type=\"submit\"\n                >\n                    <span class=\"fl-button-content\">Submit<\/span>\n                    <i\n                        class=\"fa fa-angle-right medium\"\n                        aria-hidden=\"true\"\n                    ><\/i>\n                <\/button>\n                <button\n                    class=\"was-this-helpful__feedback-button was-this-helpful__feedback-button--cancel fl-button primary disabled\"\n                    type=\"reset\"\n                >\n                    <span class=\"fl-button-content\">Cancel<\/span>\n                    <i\n                        class=\"fa fa-times-circle medium\"\n                        aria-hidden=\"true\"\n                    ><\/i>\n                <\/button>\n            <\/div>\n        <\/form>\n    <\/div>\n    <div class=\"was-this-helpful__thank-you-message\" role=\"status\">\n        <i class=\"was-this-helpful__thank-you-message-icon fa fa-check\"><\/i>\n        <p class=\"was-this-helpful__thank-you-message-text\" aria-live=\"polite\"><\/p>\n    <\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"fl-section-sidebar\"><div class=\"fl-editors-summary\" data-testid=\"fl-editors-summary\">\n    \n    <div class=\"fl-editors-summary-content\" data-testid=\"fl-editors-summary-content\">\n                    <h2>Can I Solve This on My Own or Do I Need an Attorney?<\/h2>\n                <div class=\"fl-editors-summary-content-main\" data-testid=\"fl-editors-summary-content-main\">\n            \n        <\/div>\n        <ul class=\"fl-list-style-none\">\n                            <li data-testid=\"fl-editors-summary-content-item\">\n                    <i class=\"fa fa-check medium fl-editors-summary-content-item-icon\" aria-hidden=\"true\"><\/i>\n                    Most people can choose an insurance plan on their own without legal help\n\n                <\/li>\n                            <li data-testid=\"fl-editors-summary-content-item\">\n                    <i class=\"fa fa-check medium fl-editors-summary-content-item-icon\" aria-hidden=\"true\"><\/i>\n                    <span data-sheets-root=\"1\">Healthcare systems and insurance companies are well-resourced with teams of attorneys on their side<\/span>\n\n                <\/li>\n                            <li data-testid=\"fl-editors-summary-content-item\">\n                    <i class=\"fa fa-check medium fl-editors-summary-content-item-icon\" aria-hidden=\"true\"><\/i>\n                    Complex heath care cases (such as medical malpractice, bioethics, or health advocacy) may need the support of an attorney\n\n                <\/li>\n                    <\/ul>\n                    <div class=\"fl-editors-summary-content-description\" data-testid=\"fl-editors-summary-content-description\">\n                <p>Protect your patient rights with an attorney at your side. 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