Health Insurance Mental health parity laws by state Written by Michelle Megna Michelle Megna Michelle, the former editorial director, insurance, at QuinStreet, is a writer, editor and expert on car insurance and personal finance. Prior to joining QuinStreet, she reported and edited articles on technology, lifestyle, education and government for magazines, websites and major newspapers, including the New York Daily News. Reviewed by Penny Gusner Penny Gusner Penny is an expert on insurance procedures, rates, policies and claims. She has extensive knowledge of all major insurance lines -- auto, homeowners, life and health insurance. She has been answering consumers’ questions as an analyst for more than 15 years and has been featured in numerous major media outlets, including the Washington Post and Kiplinger’s. 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Most states have enacted legislation that requires health insurance plans to provide coverage for mental health treatment that’s equal to coverage for physical illness, known as “mental health parity.” These laws may apply to all health insurance plans sold in the state, whether individual or group, but they often exclude small-group health plans (such as plans for 50 employees or less). Some states exclude “V codes” which, broadly defined, encompass antisocial behavior and interpersonal problems such as child neglect and bereavement. In October 2008, the Paul Wellstone-Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 became law, requiring health plans to cover treatment for mental illness on the same terms and conditions as medical treatment. The law forbids health insurance companies from adding higher cost-sharing rules, deductibles and out-of-pocket limits on mental health services and treatments. States can still enforce their own parity laws that are stronger than federal law. State mental health parity laws vary considerably. The National Alliance on Mental Illness tracks them (see chart below) and provides information and support for those dealing with mental illness. Types of laws in the mental health parity Comprehensive parity: Mandates equal coverage of a broad range of mental health conditions, including substance abuse disorders. Law does not exempt significant policy groups. Broad-based parity: Mandates equal coverage of a broad range of mental health conditions. Law may include some limitations or exemptions. Limited parity: Limits equal coverage to a specific list of mental health conditions and/or excludes equal coverage for significant policy groups and/or limits equal coverage for a certain durational or financial limit or cost-sharing requirements and/or allows plans to opt out of parity due to cost-increase provisions. Mandated if offered: Requires mental health coverage be equal to other medical conditions if the plan offers mental health coverage. Mandated offering: Requires a plan to offer the option of mental health coverage that is equal to coverage for other medical conditions, but buyers don’t have to take it. Minimum mandated benefit: Mandates minimum mental health coverage that is not required to be equal to other medical conditions. Definitions of conditions for the mental health parity law chart Serious mental illness: Major mental illnesses, typically defined in state statutes as schizophrenia, schizoaffective disorder, psychotic disorders, bipolar disorder, major depression, panic disorders and obsessive-compulsive disorder. Broad-based mental health disorders: A relatively broad range of mental disorders. Substance abuse disorders: Alcoholism and chemical dependency. State mental health parity laws Type of Law Policies affected Conditions covered Alabama Mandated offering. Individual, HMO, and group, 50-employee exemption. Serious mental illness. Alaska No parity law. Arizona Mandated if offered. Group, 50-employee exemption. 1 percent cost increase cap. Allows different co-pays and co-insurance. Broad-based mental health disorders. Arkansas Minimum mandated benefit. Group, employer plans with 50 or fewer employees may impose an annual maximum benefit of $7,500. Employer plans with 51 or more employees may impose an annual maximum of 8 inpatient days and 40 outpatient visits. Mental illness. California Limited parity. Individual, HMO and group. Serious mental illness and serious emotional disturbance in children. Colorado Limited parity. If offered, statute requires parity for autism. Excludes residential treatment for anorexia or bulimia. Exemption for “barebones” policies. Group. Serious mental illness; post traumatic stress disorder, dysthymia, cyclothymia, social phobia, agoraphobia with panic disorder, and general anxiety disorder. Limited coverage for anorexia and bulimia. Substance use disorders. Connecticut Comprehensive parity. Excludes mentally handicapped, learning disorders, motor skills disorders, communication disorders, caffeine-related disorders and “V” codes. Individual and group. Broad-based mental health disorders and substance use disorders. Excludes mentally handicapped, learning disorders, motor skills disorders, communication disorders, caffeine-related disorders and “V” codes. Delaware Limited parity. Individual and group. Serious mental illness, including autism and ADHD. Substance abuse disorders. District of Columbia Minimum mandated benefit. 1 percent cost increase exemption for large group plans. Minimum 60 inpatient days. Minimum 75 percent coverage of first 40 outpatient visits, 60 percent coverage for further outpatient visits. Individual and group. Broad-based mental health disorders and substance abuse disorders. Florida Minimum benefit offering. Minimum offering of no less than 30 inpatient days per benefit year. Outpatient benefits may be limited to $1,000 per benefit year. Limited substance abuse benefit offering. Group Mental illness and substance abuse disorders. Georgia Mandated offering. Allows day and visit limits for small group (2 to 50 employees) plans. Permits 30 inpatient day limit and 48 outpatient limit under individual policies. Individual and group. Broad-based mental health disorders and substance abuse disorders. Hawaii Limited parity. Group, 25-employee exemption. Serious mental illness. Idaho Limited parity. State employees only. Serious mental illness and serious emotional disturbance in children. Illinois Limited parity. 45 inpatient day and 35 outpatient visit benefit for other mental health conditions. May be subject to 50 percent co-pay and lesser of annual limit of $10,000 or 25 percent of lifetime policy limit. Group, 50-employee exemption. Serious mental illness, including pervasive developmental disorders and PTSD. More limited coverage of other mental health conditions. Indiana Broad-based parity. Cost increase cap of 4 percent. Individual, state employees, and group, 50-employee exemption. Broad-based mental health disorders and substance abuse treatment for those with mental illness. Iowa Minimum mandated benefit. Minimum benefit of 30 inpatient days and 52 outpatient visits. Group, 50-employee exemption if no coverage of mental illness is provided. Serious mental illness, including pervasive developmental disorders and autistic disorders. Kansas Minimum mandated benefit. 1 percent cost increase cap. 45 inpatient days and 45 outpatient visits annually. Minimum 30 inpatient days for other mental health and substance abuse disorders; not less than $7,500 lifetime benefit for outpatient care. Individual, HMO, state employees, and group, 25-employee exemption. Serious mental illness, including pervasive developmental disorder, autism, and ADHD. More limited coverage for other mental health and substance use disorders. Kentucky Mandated if offered. Group, 50-employee exemption. Broad-based mental health disorders and substance abuse disorders. Louisiana Minimum mandated benefit. Requirements met if plan provides 45 in-patient days and 52 out-patient visits annually. Mandated offering for other mental health disorders. HMO, state employee, and group. Serious mental illness, including Asperger’s Disorder, Intermittent explosive disorder, PTSD, Rett’s Disorder, and Tourette’s Disorder. Maine Broad-based parity. Excludes “V” codes. Mandated offering for all individual and group plans for serious mental illness. Individual and group, 20-employee exemption. Broad-based mental health disorders and substance abuse disorders. Maryland Comprehensive parity. Graduated outpatient copays. Individual, HMO and group. Broad-based mental health disorders and substance abuse disorders. Massachusetts Limited parity. Allows different copays, co-insurance and deductibles. Minimum 60 day inpatient days and 24 outpatient visits for other mental health disorders. Individual, HMO or group. Serious mental illness; serious emotional disturbance in children; substance abuse treatment for those with mental illness. Limited coverage for other mental health disorders Michigan Minimum mandated benefit HMOs Broad-based mental health disorders and substance abuse disorders. Minnesota Comprehensive parity for HMOs. Mandated if offered for individual and groups. HMO, individual and group. Broad-based mental health disorders; substance abuse disorders. Mississippi Minimum mandated benefit Cost increase cap of 1 percent. Minimum of 30 inpatient days and 52 outpatient visits per year; outpatient benefit may be limited to a maximum of $50 per visit or 50 percent of expense. Mandated offering for groups of 100 or fewer. Large groups over 100. Serious mental illness. Missouri Minimum benefit offering. Excludes mentally handicapped. Limits out-of-pocket expenses. Allows different copays, deductibles and co-insurance. Maximum of 90 inpatient days per year. Minimum 30 inpatient days and 20 outpatient visits per year for substance abuse. Individual, state employees, group. Broad-based mental health disorders. Limited coverage for substance abuse disorders. Montana Limited parity. Maximum 20 inpatient days for other mental health disorders. Outpatient treatment fo other mental health disorders may be limited to $2,000 per year. Inpatient and outpatient substance use treatment is subject to $6,000 maximum in 12-months and lifetime maximum inpatient of $12,000. Allows exclusion of mental health for “barebones” policies (12 mo. pilot). Individual and group. Serious mental illness, including autism. More limited group coverage for other mental health and substance use disorders. Nebraska Mandated if offered. 30 inpatient days annually, with minimum of 60 days per lifetime. 60 outpatient visits per lifetime. HMO and group, 15-employee exemption. Serious mental illness. More limited coverage for alcoholism. Nevada Minimum mandated benefit. Premium increase cap of 2 percent. Minimum 40 inpatient days and outpatient visits per year. Allows higher deductibles and co-pays. $9,000 inpatient and $2,500 outpatient benefit annually for substance abuse disorders. Individual, HMO, and group, 25-employee exemption. Serious mental illness. Limited coverage for substance use disorders. New Hampshire Limited parity. Minimum benefits for chemical dependency and other mental disorders. Plan imposes limits for inpatient and outpatient substance use disorders. HMO and group. Serious mental illness, including pervasive developmental disorders, autism, anorexia, bulimia, chronic PTSD. New Jersey Limited parity. Individual and group. Serious mental illness, including pervasive developmental disorder and autism. New Mexico Broad-based parity. Two percent cost increase cap for less than 50 employees; 2.5 percent cost increase cap for 50 or more employees. Thirty days inpatient and outpatient annually, May impose lifetime limit of two episodes. Group. Broad-based mental health disorders. Limited coverage for substance abuse disorders. New York Limited parity. Mandated offering for all plans. Minimum mandated benefit of 20 outpatient and 30 inpatient days for all mental illnesses (20/30 benefit) in all plans. State subsidy for mandated 20/30 benefit in small group plans. HMO and group, 50-employee exemption. Serious mental illness, including anorexia and bulimia. Serious emotional disturbance in children. Limited coverage for other mental health disorders. North Carolina Limited parity. Mandated minimum benefit of 30 combined inpatient and outpatient days and 30 office visits per year for other mental health conditions. Minimum benefits exclude substance-related disorders, sexual dysfunctions not due to organic disease, and “V” codes. Group. Requires group health insurance to offer coverage for nine major mental health disorders including post-traumatic stress disorder, obsessive compulsive disorder, anorexia nervosa and bulimia. North Dakota Minimum mandated benefit. Minimum 45 inpatient days and 30 hours outpatient services for mental health disorders. Minimum 45 inpatient days and 20 outpatient visits for substance abuse disorders. Sixty days residential. Group and HMO. Broad-based mental health disorders. Substance abuse disorders. Ohio Limited parity. Cost increase cap of 1 percent. Mandated minimum benefits for other mental health conditions. Minimum $550 annual benefit for outpatient services for other mental health disorders. Self-insured and group. Serious mental illness. Oklahoma Limited parity. Premium cost increase cap of 2 percent. HMO, self-insured, state employees, and group, 50-employee exemption. Serious mental illness. Oregon Comprehensive parity. Excludes mentally handicapped, learning disorders, paraphilias, gender identity disorders in adults and “V” codes, except V61.20, V61.21, and V62.82. Excludes tobacco or food dependencies. No requirement for over 45 days of residential mental health care. HMO and group. Broad-based mental health disorders; substance abuse disorders. Pennsylvania Minimum mandated benefit. Minimum 30 inpatient and 60 outpatient days annually. HMO and group, 50-employee exemption. Serious mental illness; serious emotional disturbance in children. Rhode Island Minimum mandated benefit. Excludes mentally handicapped, learning disorders, motor skills disorders, communication disorders, and “V” codes. Minimum 30 outpatient visits per year for mental health disorders. Minimum 30 hours outpatient and 30 days residential for substance use disorders. Individual, HMO, self-insured, and group. Broad-based mental health disorders. Substance use disorders. South Carolina Limited parity. Mandated offering of minimum benefits for all group plans. State employee plans and group, 50-employee exemption. Serious mental illness, including PTSD. State-employee plans have parity for broader set of conditions, including substance abuse. South Dakota Limited parity. Mandated offering of substance use treatment coverage. Maximum of 30 days total inpatient or outpatient in 6 mos., 90 days lifetime. Individual, HMO and group. Serious mental illness. Tennessee Minimum benefit if offered. 1 percent cost increase cap. Allows different co-pays, co-insurance, and deductibles. Minimum of 20 inpatient and 25 outpatient visits annually. Mandated offering of parity benefits for substance abuse disorders. Group, 25-employee exemption. Broad-based mental health disorders. Texas Minimum mandated benefit. Mandated offering for small groups. Allows exemptions to mandate for “barebones” policies. HMO, state employees, and group, 50-employee exemption. Serious mental illness. Utah Mandated offering. Allows different deductibles, copays, or co-insurance. Mandated offering of minimum benefit of 50 percent coverage or catastrophic coverage for small group plans. HMO and group, 50-employee exemption and hardship clause. Serious mental illness. Substance abuse disorders. Vermont Comprehensive parity. Individual, HMO, and group. Broad-based mental health disorders and substance abuse disorders. Virginia Limited parity. Mandated minimum benefit for individual and small group plans of 20 inpatient days and 20 outpatient visits. Minimum 50 percent co-insurance required after first five outpatient visits, except for serious mental illness and substance abuse disorders. HMO and group, 25-employee exclusion. Serious mental illness, includes autism and ADHD; substance abuse disorders. Washington Broad-based parity. Excludes “V” codes. Exempts residential treatment. Parity of copays, co-insurance and out-of-pocket limits; parity of deductibles and treatment limitations in 2010. Individual, HMO and group. Broad-based mental health disorders. West Virginia Limited parity. Excludes caffeine and nicotine-related disorders. Alcoholism coverage repealed. Excludes residential care. Total cost cap for large groups of 2 percent. Cost cap for groups of 25 or fewer of 1 percent. Individual and group. Serious mental illness, including anorexia and bulimia, ADHD, separation anxiety disorder and conduct disorder for 18 and under. Substance abuse disorders. Wisconsin Minimum mandated benefits. Inpatient 30 days, or at least $7,000, minus cost-sharing. Outpatient $2,000 minus cost-sharing. Group. Broad-based mental health disorders, substance abuse disorders. Wyoming No parity law. Source: National Alliance on Mental Illness (NAMI) Related ArticlesHow a history of mental illness can affect your life insurance costsMore health insurance stories Michelle MegnaContributor . .Michelle, the former editorial director, insurance, at QuinStreet, is a writer, editor and expert on car insurance and personal finance. Prior to joining QuinStreet, she reported and edited articles on technology, lifestyle, education and government for magazines, websites and major newspapers, including the New York Daily News. Related Articles How much does COBRA insurance cost? By Les Masterson A complete guide to short-term health insurance By Shivani Gite Guide to domestic partner health insurance By Chris Kissell How insurance works for same-sex couples By Susan Manning How to get your health insurer to pay for your weight-loss or bariatric surgery By Susan Manning Should you decline the health insurance plan at work? By Erik Martin ZIP Code Please enter valid ZIP See rates