Mental Health Parity Law
Summary of California’s Mental Health Parity Law
California Mental Health Parity
Background: California, like most states, has a “mental health parity” law.
The law’s mandates: California’s law generally requires health plans to eliminate mental health-specific benefit limits and cost-sharing requirements, such as higher co-payments and deductibles and limits on numbers of covered benefits which have traditionally made mental health benefits less comprehensive than other health benefits. Additionally, the law requires that every insurer that provides hospital, medical or surgical coverage shall provide coverage for the diagnosis and medically necessary treatment of those with covered conditions, including:
While this list does not include all mental health disorders, it does include almost all mental illnesses which would require numerous physician or therapy visits and/or hospital days.
Who the law applies to: California’s mental health parity law only applies to California’s private insurers. Comparable benefits are available under state sponsored programs such as MediCal and Healthy Families which offer health coverage for low income families and people with disabilities. The law does not apply to Medicare, or self-insured health plans (usually large employers whose plans are regulated only by federal law).
Oversight of the parity law: Three state agencies are involved in oversight of mental health parity.
If you have trouble accessing mental health care within an HMO plan:
Resources for Assistance with Insurance Problems
Request an MHAC Training on parity or mental health insurance access for your office or conference: