“My health insurer denied my request for inpatient addiction treatment. Now what?”

“My health insurer will only approve 2 days of residential addiction treatment at a time, and never more than 6. What can I do?”

“My health insurer does not have any doctors who prescribe Suboxone in-network. What are my rights?”

“My health insurer says my psychologist visits are not medically necessary. Is there anything I can do?”

A federal law forbids health insurers from discriminating against people with substance use or mental disorders. Health Insurance for Addiction & Mental Health Care: A Guide to the Federal Parity Law explains patients’ and providers’ rights care under this law, which is called the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, or the “federal parity law”. The Guide also briefly explains some relevant New York State laws. Although written for a New York audience, much of the Guide can be used anywhere in the country.

The Guide includes:

  • A summary of the federal parity law
  • An in-depth explanation of the federal parity law for those who want more information
  • A list of “red flags,” or signs that your insurer might be violating the law
  • A tool to help you determine what type of health plan you have
  • Information about some additional protections under New York State law
  • What to do if you can’t get health insurance coverage for substance use or mental health care
  • Sample appeals, letters, and complaints
  • And more!

If you or a loved one is having trouble accessing health insurance coverage for addiction or mental health care, this Guide is for you! Health care providers, advocates, and lawyers should also use this Guide.

Thank you to the New York Community Trust and the New York Office of Alcoholism and Substance Abuse Services for their generous support of this Guide.

 

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LAC Parity Guide 2016

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