| 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 if offered. |
Group, 50-employee exemption. 1 percent cost increase cap. Allows different co-pays and co-insurance. |
Broad-based mental health disorders.
|
| Arkansas |
| Minimum mandated benefit. |
Group,
employer plans with 50 or fewer employees may impose an annual maximum
benefit of $7,500. Employer plans with 51 or more employees may impose
an annual maximum of 8 inpatient days and 40 outpatient visits. |
Mental illness. |
| 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.
Exemption for "barebones" policies. |
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 use
disorders.
|
| Connecticut |
| Comprehensive
parity. Excludes mentally handicapped, learning disorders, motor skills
disorders, communication disorders, caffeine-related disorders and “V”
codes.
|
Individual and group. |
Broad-based
mental health disorders and substance use disorders. Excludes mentally
handicapped, learning disorders, motor skills disorders, communication
disorders, caffeine-related disorders and "V" codes. |
| Delaware |
| Limited parity. |
Individual and group. |
Serious mental illness, including autism and ADHD. Substance abuse disorders.
|
| District of Columbia |
| Minimum
mandated benefit. 1 percent cost increase exemption for large group
plans. Minimum 60 inpatient days. Minimum 75 percent coverage of first
40 outpatient visits, 60 percent coverage for further outpatient
visits. |
Individual and group. |
Broad-based mental health disorders and substance abuse disorders.
|
| Florida |
| Minimum
benefit offering. Minimum offering of no less than 30 inpatient days
per benefit year. Outpatient benefits may be limited to $1,000 per
benefit year. Limited substance abuse benefit offering. |
Group |
Mental illness and substance abuse disorders. |
| Georgia |
| Mandated
offering. Allows day and visit limits for small group (2 to 50
employees) plans. Permits 30 inpatient day limit and 48 outpatient
limit under individual policies. |
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.
45
inpatient day and 35 outpatient visit benefit for other mental health
conditions. May be subject to 50 percent co-pay and lesser of annual
limit of $10,000 or 25 percent of lifetime policy limit. |
Group, 50-employee exemption.
|
Serious mental illness,
including pervasive developmental disorders and PTSD. More limited
coverage of other mental health conditions. |
| Indiana |
| Broad-based parity. Cost increase cap of 4 percent. |
Individual, state employees, and group, 50-employee exemption.
|
Broad-based mental health disorders and substance abuse treatment for those with mental illness.
|
| Iowa |
Minimum mandated benefit.
Minimum benefit of 30 inpatient days and 52 outpatient visits. |
Group, 50-employee exemption if no coverage of mental illness is provided. |
Serious mental illness, including pervasive developmental disorders and autistic disorders. |
| Kansas |
| Minimum
mandated benefit. 1 percent cost increase cap. 45 inpatient days and 45
outpatient visits annually. Minimum 30 inpatient days for other mental
health and substance abuse disorders; not less than $7,500 lifetime
benefit for outpatient care. |
Individual, HMO, state employees, and group, 25-employee exemption. |
Serious mental illness, including pervasive developmental disorder, autism, and ADHD.
More limited coverage for other mental health and substance use disorders. |
| Kentucky |
| Mandated if offered. |
Group, 50-employee exemption. |
Broad-based mental health disorders and substance abuse disorders.
|
| Louisiana |
Minimum mandated benefit.
Requirements met if plan provides 45 in-patient days and 52 out-patient visits annually.
Mandated offering for other mental health disorders. |
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.
Minimum 60 day inpatient days and 24 outpatient visits for other mental health disorders. |
Individual, HMO or group. |
Serious
mental illness; serious emotional disturbance in children; substance
abuse treatment for those with mental illness. Limited coverage for
other mental health disorders |
| Michigan |
| Minimum mandated benefit |
HMOs |
Broad-based mental health disorders and substance abuse disorders.
|
| Minnesota |
| Comprehensive parity for HMOs. Mandated if offered for individual and groups.
|
HMO, individual and group. |
Broad-based mental health disorders; substance abuse disorders.
|
| Mississippi |
Minimum mandated benefit
Cost
increase cap of 1 percent. Minimum of 30 inpatient days and 52
outpatient visits per year; outpatient benefit may be limited to a
maximum of $50 per visit or 50 percent of expense. Mandated offering
for groups of 100 or fewer. |
Large groups over 100. |
Serious mental illness.
|
| Missouri |
| Minimum
benefit offering. Excludes mentally handicapped. Limits out-of-pocket
expenses. Allows different copays, deductibles and co-insurance.
Maximum of 90 inpatient days per year. Minimum 30 inpatient days and 20
outpatient visits per year for substance abuse. |
Individual, state employees, group. |
Broad-based mental health disorders. Limited coverage for substance abuse disorders. |
| Montana |
Limited parity.
Maximum
20 inpatient days for other mental health disorders. Outpatient
treatment fo other mental health disorders may be limited to $2,000 per
year. Inpatient and outpatient substance use treatment is subject to
$6,000 maximum in 12-months and lifetime maximum inpatient of $12,000.
Allows exclusion of mental health for "barebones" policies (12 mo.
pilot). |
Individual and group. |
Serious mental illness, including autism. More limited group coverage for other mental health and substance use disorders. |
| Nebraska |
Mandated if offered.
30 inpatient days annually, with minimum of 60 days per lifetime. 60 outpatient visits per lifetime. |
HMO and group, 15-employee exemption.
|
Serious mental illness. More limited coverage for alcoholism. |
| Nevada |
| Minimum
mandated benefit. Premium increase cap of 2 percent. Minimum 40
inpatient days and outpatient visits per year. Allows higher
deductibles and co-pays. $9,000 inpatient and $2,500 outpatient benefit
annually for substance abuse disorders. |
Individual, HMO, and group, 25-employee exemption.
|
Serious mental illness.
Limited coverage for substance use disorders. |
| New Hampshire |
Limited parity. Minimum benefits for chemical dependency and other mental disorders.
Plan imposes limits for inpatient and outpatient substance use 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. Two percent cost increase cap for less than 50 employees; 2.5
percent cost increase cap for 50 or more employees. Thirty days
inpatient and outpatient annually, May impose lifetime limit of two
episodes. |
Group. |
Broad-based mental health disorders. Limited coverage for substance abuse 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. Limited coverage for other mental health
disorders. |
| 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. |
Requires
group health insurance to offer coverage for nine major mental
health disorders including post-traumatic stress disorder, obsessive
compulsive disorder, anorexia nervosa and bulimia.
|
| North Dakota |
Minimum
mandated benefit. Minimum 45 inpatient days and 30 hours outpatient
services for mental health disorders. Minimum 45 inpatient days and 20
outpatient visits for substance abuse disorders. Sixty days
residential. |
Group and HMO. |
Broad-based mental health disorders. Substance abuse disorders.
|
| Ohio |
| Limited
parity. Cost increase cap of 1 percent. Mandated minimum benefits for
other mental health conditions. Minimum $550 annual benefit for
outpatient services for other mental health disorders. |
Self-insured and group. |
Serious mental illness. |
| Oklahoma |
| Limited parity. Premium cost increase cap of 2 percent.
|
HMO, self-insured, state employees, and group, 50-employee exemption. |
Serious mental illness. |
| Oregon |
| Comprehensive
parity. Excludes mentally handicapped, 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 |
Minimum mandated benefit.
Minimum 30 inpatient and 60 outpatient days annually. |
HMO and group, 50-employee exemption. |
Serious mental illness; serious emotional disturbance in children.
|
| Rhode Island |
Minimum
mandated benefit. Excludes mentally handicapped, learning disorders,
motor skills disorders, communication disorders, and “V” codes.
Minimum
30 outpatient visits per year for mental health disorders. Minimum 30
hours outpatient and 30 days residential for substance use disorders. |
Individual, HMO, self-insured, and group. |
Broad-based mental health disorders.
Substance use 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.
Mandated
offering of substance use treatment coverage. Maximum of 30 days total
inpatient or outpatient in 6 mos., 90 days lifetime. |
Individual, HMO and group. |
Serious mental illness. |
| Tennessee |
Minimum benefit if offered.
1 percent cost increase cap.
Allows
different co-pays, co-insurance, and deductibles. Minimum of 20
inpatient and 25 outpatient visits annually. Mandated offering of
parity benefits for substance abuse disorders. |
Group, 25-employee exemption. |
Broad-based mental health disorders. |
| Texas |
Minimum mandated benefit.
Mandated offering for small groups. Allows exemptions to mandate for "barebones" policies. |
HMO, state employees, and group, 50-employee exemption. |
Serious mental illness. |
| Utah |
| Mandated
offering. Allows different deductibles, copays, or co-insurance.
Mandated offering of minimum benefit of 50 percent coverage or
catastrophic coverage for small group plans. |
HMO and group, 50-employee exemption and hardship clause. |
Serious mental illness.
Substance abuse disorders. |
| Vermont |
| Comprehensive parity. |
Individual, HMO, and group. |
Broad-based mental health disorders and substance abuse disorders. |
| Virginia |
| Limited
parity. Mandated minimum benefit for individual and small group plans
of 20 inpatient days and 20 outpatient visits. Minimum 50 percent
co-insurance required after first five outpatient visits, except for
serious mental illness and substance abuse disorders. |
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 percent. Cost cap for groups of 25 or fewer of 1 percent.
|
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 |
Minimum mandated benefits.
Inpatient 30 days, or at least $7,000, minus cost-sharing. Outpatient $2,000 minus cost-sharing. |
Group. |
Broad-based mental health disorders, substance abuse disorders. |
| Wyoming |
No parity law.
|
|
| Source: National Alliance on Mental Illness (NAMI) |
