Mental Health Parity

Historically, health insurance covered mental health care differently than other medical care. Recent laws have begun bringing them into balance.

Calvin Dodson, 50, is partially blind, suffers from hypertension, diabetes, loss of body control due to seizures and lives alone in his small apartment. He depends on caregivers to look after him, prepare his meals, wash his apartment and clothes, make sure he gets his medications and insulin shots. He benefits from the Personal Preferences Project, which pays him money to hire the caregiver he wants and feels most comfortable with. By hiring people he trusts, he feels more empowered to live an independent and healthy life, while being able to compensate his caregiver properly.

Mary Leggett, 54, is Calvin's caregiver of 5 years. She has worked closely with him and they are more like brother and sister. She takes care of many of his daily chores and needs, since he cannot look after himself due to his mental and physical disabilities.

She cooks, cleans, does his hair and some personal hygiene and takes him out most days.

Traditionally, insurers and employers have covered treatment for mental health conditions differently than treatment for physical conditions.

Coverage for mental health care had its own (usually higher) cost-sharing structure, more restrictive limits on the number of inpatient days and outpatient visits allowed, separate annual and lifetime caps on coverage, and different prior authorization requirements than coverage for other medical care.

Altogether, these coverage rules made mental health benefits substantially less generous than benefits for physical health conditions.