Even Under Parity Rules, Plans May Charge Higher Specialty Copays For Counseling

(By – Michelle Andrews, Kaiser Health News)

This week I addressed reader questions about insurance coverage for mental health counseling and infertility, as well as what would happen if a state expanded its Medicaid program midyear.

Q. My son requires regular counseling from a psychologist to treat his attention-deficit/hyperactivity disorder. These are treated as medical specialty visits rather than general medical appointments in terms of copay requirements. Why does this coverage difference exist and is it consistent with the federal requirement that there be parity between medical and behavioral health coverage?

A. The Mental Health Parity and Addiction Equity Act of 2008 requires most health plans to provide mental health and substance abuse treatment benefits that are at least as generous as the plan’s benefits for medical and surgical care. Read more…


Kaiser Health News is a nonprofit national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.


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