Substantial Improvements to Mental Health and Substance Use Disorder Coverage in Response to the Mental Health Parity and Addiction Equity Act of 2008. Financial Requirements

11/01/2013

Inpatient -- Almost All Plans Eliminated Higher Cost-Sharing

In 2010, 90% of a nationally representative sample of large employers' behavioral health benefits had inpatient financial requirements (e.g., deductibles, copays, or coinsurance) that conformed with MHPAEA requirements. By 2011, virtually all 230 large employer-based plans in another sample had inpatient benefits that conformed to MHPAEA standards.

Outpatient -- Majority of Plans Lower Copays for MH/SUD

In 2010, about 70% of large employers' plans had copays or coinsurance rates for outpatient MH/SUD benefits that were consistent with MHPAEA. In 2011, about 80% of the 140 plans tested used outpatient in-network copays that conformed with MHPAEA standards.

Separate Deductibles -- No Longer in Use

By 2011, nearly all plans had eliminated the use of separate deductibles in which MH/SUD out-of-pocket costs did not accumulate toward a single deductible combined with their medical/surgical benefits. Even in 2010, only 3.2% of plans used separate deductibles.

 

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