Most states have enacted legislation that requires health insurance plans to provide coverage for mental health treatment that's equal to coverage for physical illness, known as "mental health parity." These laws may apply to all health plans sold in the state, whether individual or group, but they often exclude small-group health plans (such as 50 employees or less). Some states exclude "V codes" which, broadly defined, encompass health problems for reasons other than injury and illness. Examples include antisocial behavior and interpersonal problems.
State mental health parity laws vary considerably. The National Alliance on Mental Illness tracks them (see chart below) and provides information and support for those dealing with mental illness.
| Type of Law |
Policies affected |
Conditions covered |
| Alabama |
| Mandated offering. |
Individual, HMO, and group, 50-employee exemption. |
Serious mental illness. |
| Alaska |
| No parity law. |
| Arizona |
| Mandated it offered. 1% cost increase cap. Allows different copays and co-insurance.
|
Group, 50-employee exemption. |
Broad-based mental health disorders.
|
| Arkansas |
| Limited parity. 1.5% cost increase cap. |
Group, 50-employee exemption. Excludes state employees.
|
Broad-based mental health disorders and substance abuse disorders.
|
| California |
| Limited parity. |
Individual, HMO and group.
|
Serious mental illness and serious emotional disturbance in children.
|
| Colorado |
| Limited parity. If offered, statute requires parity for autism. Excludes residential treatment for anorexia or bulimia.
|
Group. |
Serious mental illness; post traumatic stress disorder, dysthymia, cyclothymia, social phobia, agoraphobia with panic disorder, and general anxiety disorder. Limited coverage for anorexia and bulimia. Substance abuse disorders.
|
| Connecticut |
| Comprehensive parity. Excludes mental retardation, learning disorders, motor skills disorders, communication disorders, caffeine-related disorders and “V” codes.
|
Individual and group. |
Broad-based mental health disorders and substance abuse disorders.
|
| Delaware |
| Limited parity. |
Individual and group. |
Serious mental illness, including autism and ADHD. Substance abuse disorders.
|
| District of Columbia |
| Minimum mandated benefit. 1% cost increase exemption. |
Individual and group. |
Broad-based mental health disorders and substance abuse disorders.
|
| Florida |
| No parity law. |
| Georgia |
| Mandated offering. Allows day and visit limits for small group (2 to 50 employees) and individual plans.
|
Individual and group. |
Broad-based mental health disorders and substance abuse disorders.
|
| Hawaii |
| Limited parity. |
Group, 25-employee exemption.
|
Serious mental illness. |
| Idaho |
| Limited parity. |
State employees only. |
Serious mental illness and serious emotional disturbance in children.
|
| Illinois |
| Limited parity. |
Group, 50-employee exemption.
|
Serious mental illness, including pervasive developmental disorders and PTSD. |
| Indiana |
| Broad-based parity. Cost increase cap of 4%. |
Individual, state employees, and group, 50-employee exemption.
|
Broad-based mental health disorders and substance abuse treatment for those with mental illness.
|
| Iowa |
| Limited parity. |
Group, 50-employee exemption. |
Serious mental illness, including pervasive developmental disorders and autistic disorders. |
| Kansas |
| Minimum benefit if offered. 1% cost increase cap. |
Individual, HMO, state employees, and group, 25-employee exemption. |
Serious mental illness, including pervasive developmental disorder, autism, and ADHD. |
| Kentucky |
| Broad-based parity. |
Group, 50-employee exemption. |
Broad-based mental health disorders and substance abuse disorders.
|
| Louisiana |
| Limited parity. Mandated offering for other mental health disorders. Requirements met if plan provides 45 in-patient days and 52 out-patient visits annually.
|
HMO, state employee, and group. |
Serious mental illness, including Asperger’s Disorder, Intermittent explosive disorder, PTSD, Rett’s Disorder, and Tourette’s Disorder.
|
| Maine |
| Broad-based parity. Excludes “V” codes. Mandated offering for all individual and group plans for serious mental illness.
|
Individual and group, 20-employee exemption.
|
Broad-based mental health disorders and substance abuse disorders.
|
| Maryland |
| Comprehensive parity. Graduated outpatient copays. |
Individual, HMO, and group.
|
Broad-based mental health disorders and substance abuse disorders.
|
| Massachusetts |
| Limited parity. Allows different copays, co-insurance and deductibles. |
Individual, HMO, or group, 50-employee exemption. |
Serious mental illness; serious emotional disturbance in children; substance abuse treatment for those with mental illness.
|
| Michigan |
| No parity. |
| Minnesota |
| Comprehensive parity for HMOs; mandate if offered for individual and groups.
|
HMOs; individual and group. |
Broad-based mental health disorders; substance abuse disorders.
|
| Mississippi |
| No parity; minimum mandated benefits for large groups. Cost increase cap of 1%.
|
| Missouri |
| Mandated offering with limitations. Excludes mental retardation. Limited substance abuse coverage. Limits out-of-pocket expenses. Allows different copays, deductibles, and co-insurance. Maximum of 90 inpatient days per year.
|
Individual, state employees, group. |
Broad-based mental health disorders. |
| Montana |
| Limited parity. |
Individual and group. |
Serious mental illness, including autism. |
| Nebraska |
| Mandated if offered. |
HMO and group, 15-employee exemption.
|
Serious mental illness. |
| Nevada |
| Limited parity. Premium increase cap of 2%. Sets minimum benefit for inpatient days and outpatient visits. Allows higher deductibles and copays.
|
Individual, HMO, and group, 25-employee exemption.
|
Serious mental illness. |
| New Hampshire |
| Limited parity. Minimum benefits for chemical dependency and other mental disorders. |
HMO and group. |
Serious mental illness, including pervasive developmental disorders, autism, anorexia, bulimia, chronic PTSD.
|
| New Jersey |
| Limited parity. |
Individual and group. |
Serious mental illness, including pervasive developmental disorder and autism. |
| New Mexico |
| Broad-based parity. 2% cost increase cap for less than 50 employees; 2.5% cost increase cap for 50 or more employees.
|
Group. |
Broad-based mental health disorders. |
| New York |
| Limited parity. Mandated offering for all plans. Minimum mandated benefit of 20 outpatient and 30 inpatient days for all mental illnesses (20/30 benefit) in all plans. State subsidy for mandated 20/30 benefit in small group plans.
|
HMO and group, 50-employee exemption. |
Serious mental illness, including anorexia and bulimia. Serious emotional disturbance in children.
|
| North Carolina |
| Limited parity. Mandated minimum benefit of 30 combined inpatient and outpatient days and 30 office visits per year for other mental health conditions. Minimum benefits exclude substance-related disorders, sexual dysfunctions not due to organic disease, and “V” codes.
|
Group. |
Serious mental illness, including post-traumatic stress disorder, obsessive compulsive disorder, anorexia nervosa and bulimia.
|
| North Dakota |
| No parity; mandated minimum benefits. |
| Ohio |
| Limited parity. Cost increase cap of 1%. Mandated minimum benefits for other mental health conditions.
|
Self-insured and group. |
Serious mental illness. |
| Oklahoma |
| Limited parity. Premium cost increase cap of 2%.
|
HMO, self-insured, state employees, and group, 50-employee exemption. |
Serious mental illness. |
| Oregon |
| Comprehensive parity. Excludes mental retardation, learning disorders, paraphilias, gender identity disorders in adults and “V” codes, except V61.20, V61.21, and V62.82. Excludes tobacco or food dependencies. No requirement for over 45 days of residential mental health care.
|
HMO and group. |
Broad-based mental health disorders; substance abuse disorders.
|
| Pennsylvania |
| No parity; mandated minimum benefits only. |
HMO and group, 50-employee exemption. |
Serious mental illness; serious emotional disturbance in children.
|
| Rhode Island |
| Minimum mandated benefit. Excludes mental retardation, learning disorders, motor skills disorders, communication disorders, and “V” codes. Limited substance abuse treatment. Outpatient limit of 30 visits, except for medication management.
|
Individual, HMO, self-insured, and group. |
Broad-based mental health disorders. |
| South Carolina |
| Limited parity. Mandated offering of minimum benefits for all group plans. |
State employee plans and group, 50-employee exemption. |
Serious mental illness, including PTSD. State-employee plans have parity for broader set of conditions, including substance abuse.
|
| South Dakota |
| Limited parity. |
Individual, HMO, and group. |
Serious mental illness. |
| Tennessee |
| Limited parity. Cost increase cap of 1%. Allows different copays, co-insurance, and deductibles. Minimum of 20 inpatient and 25 outpatient visits annually.
|
Group, 25-employee exemption. |
Broad-based mental health disorders. |
| Texas |
| Limited parity. Mandated offering for small groups. Allows exemptions to mandate for “barebones” policies. Minimum inpatient and outpatient visits.
|
HMO, state employees, and group, 50-employee exemption. |
Serious mental illness. |
| Utah |
| Limited parity. Allows different deductibles, copays, or co-insurance. Mandated offering of minimum benefit of 50% coverage or catastrophic coverage for small group plans.
|
HMO and group, 50-employee exemption and hardship clause. |
Serious mental illness. |
| Vermont |
| Comprehensive parity. |
Individual, HMO, and group. |
Broad-based mental health disorders; substance abuse disorders. |
| Virginia |
| Limited parity. Mandated minimum benefit for individual and small group plans. |
HMO and group, 25-employee exclusion. |
Serious mental illness, includes autism and ADHD; substance abuse disorders. |
| Washington |
| Broad-based parity. Excludes “V” codes. Exempts residential treatment. Parity of copays, co-insurance and out-of-pocket limits; parity of deductibles and treatment limitations in 2010. |
Individual, HMO, and group. |
Broad-based mental health disorders. |
| West Virginia |
| Limited parity. Excludes caffeine and nicotine-related disorders. Alcoholism coverage repealed. Excludes residential care. Total cost cap for large groups of 2%. Cost cap for groups of 25 or fewer of 1%.
|
Individual and group. |
Serious mental illness, including anorexia and bulimia, ADHD, separation anxiety disorder and conduct disorder for 18 and under. Substance abuse disorders.
|
| Wisconsin |
| No parity; minimum mandated benefits. |
Group. |
|
| Wyoming |
| No parity law. |
| Source: National Alliance on Mental Illness |
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