Mental Health Parity Notice
Effective October 1, 2013, Maryland law requires health insurance carriers to provide specified information about mental health and substance use benefits to their members enrolled in Maryland individual plans or Maryland fully insured groups.
Members can view their mental health and substance use benefits by logging in to My Account. If you have not registered, please follow the steps indicated.
Once you have logged in, select the "My Coverage" tab at the top of the page and then select "Benefit Details." The benefits shown reflect current benefits only.
Legal Requirements for Mental Health and Substance Abuse Benefits in Maryland
Individual Benefit Plans
Individual plans that have mental health or substance abuse benefits covered under the policy, must comply with the Federal parity requirements for policy years beginning on or after July 1, 2014. Mental health benefits are subject to copay or coinsurance depending on the plan selected, and coverage for mental health and substance abuse services generally cannot be more restrictive than coverage for medical and surgical services. All Maryland individual health benefit plans are compliant with Maryland law.
Fully-Insured Group Health Benefit Plans with 51 or More Employees
Maryland fully-insured group health benefit plans with 51 or more employees need to comply with Federal Mental Health Parity Law. The federal law prohibits group health plans with 51 or more employees that provide mental health benefits from establishing more restrictive financial requirements (e.g., deductibles, coinsurance, copayments, out-of-pocket maximums) or treatment limitations (day/visit limits) for mental health or substance abuse disorder services than those established for medical and surgical benefits. The benefits of all CareFirst Maryland fully-insured group health plans with 51 or more employees are compliant with the federal law
Fully-Insured Group Health Benefit Plans with Less Than 51 Employees
The Federal Mental Health Parity and Addiction Equity Act (the Parity Act) does not cover Maryland grandfathered health benefit plans with less than 51 employees. Rather, grandfathered small group plans are governed by Maryland health and substance use disorder laws. Fully-insured non-grandfathered plans must comply with the Parity Act in accordance with the Patient Protection and Affordable Care Act and Maryland law. The benefits of all CareFirst Maryland fully-insured group health plans comply with applicable federal and Maryland law. Outpatient benefits for all plans are subject to copay or coinsurance depending on the plan selected.
If you require additional information about mental health and substance use benefits, please contact the Maryland Insurance Administration (MIA). or call 410-468-2000. If you wish to write the MIA, the address is 200 St. Paul Place, Suite 2700, Baltimore, Maryland 21202.
Note: You may authorize your insurer in writing to share your health information with a third party such as a family member, employer, lawyer, broker or unrelated party by completing and submitting an authorization form. CareFirst will provide an Authorization Form for Information Release by standard mail within 10 business days after a request for the form is received.
If you have additional questions about how CareFirst protects your personal, financial and medical information, please call the CareFirst Privacy Office at 800-853-9236.