Mental Health Benefits & Association Health Plans

Summary of Association Health Plan Obligations Regarding Mental Health Care

Mental Health Benefits

Mental health benefits concern the care of an individual’s psychological, social, and emotional well-being. Lab tests and other screenings may also be used in the diagnosis of mental health issues. Healthcare providers who treat mental illness and related conditions include psychiatrists, psychologists, and counselors. Treatment may involve counseling and medication.

Mental health benefits are not mandatory for large group association health insurance plans. If mental health benefits are offered then the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires the large group association health plan to have financial requirements and treatment limitations for mental health and substance abuse benefits that are “no more restrictive than those placed on medical and surgical benefits.”

Mental health benefits are one of the mandatory 10 essential health benefits of the Affordable Care Act (ACA). Small group health plans are required by the ACA to provide mental health benefits. When covered by an association health plan, mental health benefits cannot have annual dollar limits or lifetime limits. However, as stated earlier, mental health benefits are optional for large group association health plans.