February 2019
The Mental Health Parity and Addiction Equity Act of 2008 requires that mental health and substance use disorder coverage are comparable to medical coverage. The Affordable Care Act further expanded Mental Health Parity requirements by ensuring plans offered through the Health Insurance Marketplace, such as L.A. Care Covered, provide many behavioral health treatments and services.
L.A. Care meets all these requirements, which include:
- Copays, coinsurance, and out-of-pocket maximums
- Limitations on services utilization, such as limits on the number of inpatient days or outpatient visits that are covered
- Coverage for out-of-network providers
- Criteria for medical necessity determinations
For more information on the Mental Health Parity and Addiction Equity Act, please visit the California Department of Managed Health Care.