Understanding Mental Health Coverage and Appeals

Mental health and substance-use coverage depends on the plan and applicable law. Certain plans are subject to parity requirements that restrict unequal treatment of these benefits compared with medical and surgical benefits. This does not mean every service is covered or every authorization requirement is prohibited. Review the plan documents, network, cost sharing and any denial notice. Ask the plan for its reason and appeal instructions, including deadlines. A qualified benefits adviser or the appropriate regulator can explain available complaint and appeal routes.