Mental Health Parity Notice
Protection of mental health and substance use disorder benefits.
The Mental Health Parity and Addiction Equity Act (MHPAEA) prohibits health plans from imposing barriers on access to mental health or substance use disorder benefits that don't apply to medical and surgical benefits. Learn about your legal rights, the information your health plan must give you and how to appeal a denied benefit claim.
Maryland Law
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.
What is Mental Health Parity?
Mental health parity is the application of equal treatment and comparable limitations to care for mental health and substance use disorder care as other medical and surgical care. Financial restrictions and limitations to mental health and substance use disorder services generally cannot be more restrictive than the financial restrictions and limitations for medical and surgical services. There are federal and state laws governing mental health parity.
For more information visit the CMS website and the DOL website.
Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; Technical Amendment to External Review for Multi-State Plan Program
Publication Date:
11/13/2013
Effective Dates:
These final regulations are effective on January 13, 2014, except that the technical amendments to 29 CFR 2590.715-2719 and 45 CFR 147.136 are effective on December 13, 2013.
Effective Date:
01/13/2014
Document Number:
2013-27086
Document Citation:
78 FR 68240
Page:
68240-68296
(57 pages)
Your Benefit Plan
Your access to mental health and substance use disorder benefits is protected under the law.
CareFirst BlueCross BlueShield (CareFirst) members can view their mental health and substance use disorder benefits by logging in to My Account. If you haven’t registered, please follow the steps indicated. Once 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.
CareFirst Third-Party Administrators (CFA/TPA) and ASO accounts can contact their Employers to get account information.
CareFirst's Mental Health Parity
Click here for a summary of CareFirst's mental health parity practices.
If additional information is still needed, please complete and submit this form or call the number on the back of your member ID card to speak with a representative. Please allow 1–2 weeks for a response or outreach from a CareFirst representative.
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 ten (10) business days after a request for the form is received.