Mental Health Parity
Know Your Rights for Mental Health, Including Autism Services, and Substance Use Disorder Treatment
Access to treatment for mental health, including autism Services, and substance use disorders is essential to the health and well-being of Pennsylvanians. Insurance coverage for mental health, including autism Services, and substance use disorder benefits is critical to ensuring consumers can access and afford these services.
Pennsylvania has the Mental Health Parity and Addiction Equity Act (MHPAEA) that requires mental health and substance use disorder parity, which means that your health insurance company is required by law to provide you with the same level of health insurance coverage for mental health and substance abuse disorder treatment as you would have for medical/surgical services.
But before we can discuss the benefits and rights to which you are entitled, you need to understand whether your health insurance plan covers mental health and substance use disorder benefits.
The MHPAEA does not mandate insurance plans to offer mental health or substance abuse treatment benefits; however, in Pennsylvania, Act 106 requires minimum coverage for alcohol and substance use disorder treatment, and the Affordable Care Act requires certain health insurance plans to cover these benefits. The first step is figuring out what kind of health insurance coverage you have.
What type of insurance do you have?
The first step in understanding your mental health and substance use disorder treatment benefits is to determine what type of insurance you have.
Below are the four main types of health insurance coverage. Select the option that applies to you to learn more about parity requirements for your type of insurance.
You have Individual Health Insurance if you bought your plan from Pennie® or directly from an insurance company.
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You have Employer-sponsored Insurance if you get your health insurance through your employer.
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You have Government-sponsored Insurance if you get your insurance through Medicaid, Medicare, or CHIP.
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If you do not have health insurance, there are resources available and even ways to get coverage.
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Have Questions?
Visit our
Parity Frequently Asked Questions page to learn more.
Need Help?
If you don't think you fit into any of these categories or are not sure what type of coverage you have, we can help! Visit the Pennsylvania Insurance Department's Consumer Services Bureau online or
our customer service team at 1-877-881-6388.
If you are having difficulty accessing your mental health or addiction treatment coverage view and print our user guides: