Understanding Pennsylvania’s Mental Health Parity Laws

The Northwest Pennsylvania (NW PA) Veteran Suicide Prevention Program operates on a three-pronged approach involving healthcare providers, community organizations, and Veterans and their families in the 15 counties of NW PA. The Pennsylvania Department of Military and Veterans Affairs (PA-DMVA) is an active partner and responsible for ensuring that the Program integrates current Veteran suicide prevention initiatives throughout Pennsylvania. The following information is provided by the PA-DMVA in conjunction with the Pennsylvania Insurance Department to explain health insurance regulations for mental health and substance use disorder (MH/SUD) treatment under the federal Mental Health Parity and Addiction Equity Act.

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Tools to Better Understand Mental Health and Substance Use Disorder Health Insurance Regulations

Thousands of Veterans throughout the commonwealth experience mental illness or SUD. The federal Mental Health Parity and Addiction Equity Act requires health plans that cover MH/SUD to cover these services “in parity” with the coverage of other medical and surgical benefits. That means many details of the plan – such as cost-sharing, limits on the number of visits, and non-numerical treatment limits – may not be more restrictive than for most other medical and surgical benefits (i.e., there must be equivalence in cost-sharing and visit limits).

Access Pennsylvania Parity Law Information Online

The NW PA Veteran Suicide Prevention Program website now offers detailed information about the Mental Health Parity and Addiction Equity Act for those covered by health insurance in Pennsylvania.

For healthcare providers, we answer the following questions:

· Which health plans are subject to the parity law?

· What are some of the signs that may indicate a violation of the parity law?

· How can healthcare providers assist a patient if a parity law violation is suspected?

For Veterans and their families, we answer the following questions:

· How do I know if the parity law applies to my health insurance plan?

· How does the parity law apply to my insurance coverage?

· How can I tell if my health insurance plan follows the parity law?

· What can I do if I think my health insurance plan isn’t following the parity law?

A core component of suicide prevention is seeking care for any mental health concerns. The isolation experienced by many during the COVID-19 pandemic underscores the importance of parity as we collectively aim to meet the increased demands placed on our mental health care system.

After reading the information provided on our website, if you still have questions about the parity law and how it applies to you, or if you wish to file a complaint, please visit the Pennsylvania Insurance Department’s Consumer Services Bureau or call the hotline at 1-877-881-6388. To connect with the Veteran community, please visit PAVET Connect.

Looking to Get Involved?

Whether you identify as a healthcare provider, community organization, or Veteran, there are several opportunities through the NW PA Veteran Suicide Prevention Program and PERU to connect to resources, participate in educational training, and promote harm reduction strategies. We are actively recruiting healthcare and community partners to work with us in meeting our goals and objectives. To learn more, visit the program website at theresilientveteran.org.

Need Help? Know Someone Who Does? Contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use the online Lifeline Crisis Chat. Both are free and confidential. You’ll be connected to a skilled, trained counselor in your area.