Mental Health Parity by State (2026)
About this article
Sourced from primary statutes (U.S. Code, CFR, state compiled statutes) and official government agency guidance. Written in plain language for general understanding — this is educational content, not legal advice. Our editorial standards
Compare by state
Statute citations are verified per state. Select a state to jump to its full section below.
| Primary statute | |
|---|---|
| Alabama | Alabama Department of Mental Health Act, Ala. Code § 22-50-1 et seq. |
| Alaska | Alaska Insurance Requirements — Alaska Stat. § 21.42 |
| Arizona | A.R.S. § 20-826.04 — Arizona autism spectrum disorder coverage mandate |
| Arkansas | Arkansas Mental Health Coverage Requirements, Ark. Code § 23-86-301 et seq. |
| California | California Health & Safety Code § 1374.72 — Mental Health Parity Act |
| Colorado | C.R.S. § 10-16-104 — mental health and substance use disorder coverage requirements |
| Connecticut | CGS § 38a-514b — Autism spectrum disorder coverage |
| Delaware | Delaware Mental Health Parity, 18 Del. C. § 3343 |
| District of Columbia | D.C. Mental Health Parity Act, D.C. Code § 31-3171 et seq. |
| Florida | Florida Baker Act, Fla. Stat. § 394 |
| Georgia | O.C.G.A. § 33-24-44.1 — Autism Spectrum Disorder Coverage |
| Hawaii | Hawaii Substance Abuse Coverage — HRS § 431:10A-118 |
| Idaho | Idaho Code § 41-3901 et seq. — mental health insurance coverage requirements |
| Illinois | 215 ILCS 5/370c — Illinois mental health parity insurance requirements |
| Indiana | Indiana Code § 27-8-5-15 — state mental health parity coverage requirements |
| Iowa | Iowa Code § 514C.22 — Mental Health Parity |
| Kansas | K.S.A. § 40-2,105a — Mental Health Insurance Coverage |
| Kentucky | KRS § 304.17A-142 — Autism Spectrum Disorder Coverage |
| Louisiana | Louisiana Mental Health Coverage Mandates, La. R.S. § 22:1043 |
| Maine | 24-A M.R.S.A. § 2843 — Maine Mental Health Parity Act |
| Maryland | Maryland Mental Health Parity, MD Code, Insurance § 15-802 |
| Massachusetts | MGL c. 175, § 47B — Massachusetts mental health parity requirements |
| Michigan | Michigan Mental Health Code, MCL § 330.1001 et seq. |
| Minnesota | Minn. Stat. § 62Q.47 — Mental Health Parity |
| Mississippi | Miss. Code Ann. § 83-9-35 — mental health and substance use disorder insurance requirements |
| Missouri | Missouri Mental Health Parity, RSMo § 376.1550 |
| Montana | Mont. Code Ann. § 33-22-706 — mental health insurance mandates |
| Nebraska | Neb. Rev. Stat. § 44-791 — Mental Health Insurance Coverage |
| Nevada | NRS 689A.0435 — Autism Spectrum Disorder Coverage |
| New Hampshire | RSA 417-E:1 — NH Mental Health Parity Act |
| New Jersey | NJ autism insurance coverage mandate, N.J.S.A. 17B:27A-19.31 |
| New Mexico | NMSA § 59A-23E-18 et seq. — mental health coverage requirements |
| New York | NY Insurance Law § 3221(l)(5) — Timothy's Law mental health parity |
| North Carolina | N.C. Gen. Stat. § 58-3-190 — Autism spectrum disorder coverage mandate |
| North Dakota | N.D. Cent. Code § 26.1-36 — Health Insurance Requirements |
| Ohio | Ohio Rev. Code § 3922.48 — required insurance coverage for autism spectrum disorder |
| Oklahoma | Oklahoma Insurance Code, Okla. Stat. tit. 36 |
| Oregon | Oregon Mental Health Parity Act — ORS § 743A.168 |
| Pennsylvania | Pennsylvania Mental Health and Intellectual Disabilities Act, 50 P.S. § 7101 |
| Rhode Island | R.I. Gen. Laws § 27-38.2 — Rhode Island Mental Health Parity Act |
| South Carolina | S.C. Code § 38-71-280 — Alcohol and Drug Abuse Coverage |
| South Dakota | SDCL Ch. 27A-1 — Mental Health Commitment |
| Tennessee | TCA § 56-7-2360 — Mental Health Insurance Coverage |
| Texas | Texas SUD Coverage Requirement, Tex. Ins. Code Ch. 1355 |
| Utah | Utah Mental Health Insurance Coverage — Utah Code § 31A-22-625 |
| Vermont | 8 V.S.A. § 4089b — Vermont Mental Health Parity Act |
| Virginia | Virginia Mental Health Law, Va. Code § 37.2 et seq. |
| Washington | Washington Mental Health Parity Act, RCW 48.44.341 |
| West Virginia | W. Va. Code § 33-16-3a — Mental health coverage |
| Wisconsin | Wis. Stat. § 632.89 — Mental Health and Substance Use Disorder Parity |
| Wyoming | Mental Health Parity and Addiction Equity Act, 29 U.S.C. § 1185a |
What is this right?
The Mental Health Parity and Addiction Equity Act passed in 2008, after Senator Paul Wellstone's family and decades of advocacy by mental health organizations finally pushed it through. The basic rule: if a health plan covers mental health and substance use disorder benefits, those benefits have to be at least as generous as medical and surgical benefits — same copays, same deductibles, same visit limits, same prior authorization rules.
In practice that means your plan cannot charge higher copays for therapy than for a regular doctor visit, cannot impose stricter visit caps on mental health treatment, and cannot require prior authorization for mental health care if it doesn't require it for comparable medical care. Compliance has been spotty for years — regulator audits routinely find parity violations. The 2024 final rule strengthened the comparative-analysis requirement, though as of mid-2025 federal enforcement of that specific rule is on hold pending litigation.
When does it apply?
Parity rules apply when:
- Your plan covers mental health or substance use disorder services (most employer plans and all ACA marketplace plans must).
- Your insurer denies, limits, or restricts mental health treatment.
- Your insurer imposes requirements — prior authorization, step therapy, higher cost-sharing — more restrictively for mental health than for medical/surgical care.
- You cannot find in-network mental health providers (the "ghost network" problem — listed providers who are not really accepting patients).
What parity requires:
- Financial requirements. Copays, deductibles, and coinsurance for MH/SUD care cannot exceed what applies to medical/surgical care in the same classification (inpatient, outpatient, emergency, prescription drugs).
- Treatment limitations. Visit limits, prior auth, and other restrictions on MH/SUD care cannot be tighter than for comparable medical care.
- Non-quantitative treatment limitations (NQTLs). Prior auth, step therapy, network adequacy, medical necessity criteria — all have to be applied no more stringently to MH/SUD than to medical/surgical benefits. The 2024 rule made this comparative analysis more rigorous on paper.
Three myths:
- "My plan does not have to cover mental health." All ACA marketplace plans and most employer plans must cover mental health as an essential health benefit. Small employer plans that do offer MH coverage have to comply with parity.
- "Parity means unlimited therapy." No. Parity means the MH limits cannot be stricter than medical/surgical limits. If specialist visits are capped at 30 per year, therapy visits can be too.
- "Insurer denied it, so it must not be covered." Many denials are themselves parity violations. If your plan covers comparable medical care without prior authorization but requires it for mental health, that is facially unequal.
What to Do If Your Insurer Denies or Limits Mental Health Coverage
Step 1: Request your plan's Summary of Benefits and Coverage (SBC) and compare MH/SUD benefits to medical/surgical benefits. Look for differences in copays, visit limits, prior authorization requirements, and network adequacy.
Step 2: If your claim is denied, request the specific reason in writing. Ask: "Does the plan apply the same requirement to comparable medical/surgical benefits?" This is the parity question.
Step 3: File an internal appeal with your insurer. Under the ACA, you have the right to appeal any denial. Cite the MHPAEA and request a comparative analysis showing how the limitation complies with parity.
Step 4: If the internal appeal fails, request an external review through your state insurance department. An independent reviewer will assess whether the denial complies with parity requirements.
Step 5: File a complaint with the DOL (for employer plans) at askebsa.dol.gov or call 1-866-444-3272, or with your state insurance department (for individual/marketplace plans). You can also contact CMS at 1-877-267-2323.
What should you NOT do?
Don't accept a denial without questioning it. Mental health claim denials are frequently parity violations. The insurer must prove the denial meets parity standards if challenged.
Don't assume your insurer is complying with parity. Federal and state enforcement agencies have found widespread parity violations across the industry. Scrutinize any limitation on mental health coverage.
Don't give up after one appeal. External review is independent of the insurer and frequently reverses denials. You have nothing to lose by pursuing it.
Don't wait for approval to get emergency mental health care. EMTALA requires screening and stabilization for psychiatric emergencies, and parity means emergency MH/SUD care must be covered on the same terms as medical emergencies.
Worked example
ScenarioYour insurance covers unlimited visits to a physical therapist but tries to cap you at 20 therapy sessions a year for mental health.
OutcomeThat kind of stricter limit can violate the federal Mental Health Parity and Addiction Equity Act, which bars treatment limits on mental-health and substance-use benefits that are more restrictive than those on comparable medical/surgical benefits. You can appeal the denial and report it to regulators.
Verified against MHPAEA (2008) — parity in financial requirements and treatment limitations. State parity laws may add protections, especially for plans outside federal coverage; see your state's section. Educational information, not legal or medical advice.
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What does 'mental health parity' actually mean?
It means your health plan can't treat mental-health and substance-use care worse than physical health care. Copays, coinsurance, visit limits, and prior-authorization rules for therapy or addiction treatment generally must be no more restrictive than those for medical or surgical care.
Does my insurance have to cover therapy or addiction treatment?
If your plan covers mental-health or substance-use benefits — and most must — federal parity law requires equal terms with medical care. Some plan types are exempt, but state law often fills the gap. Check your state's section above.
What can I do if my mental-health claim is denied?
Appeal the denial with your insurer (ask for the specific reason in writing), then request an external review. You can also complain to your state insurance regulator or the U.S. Department of Labor. A parity violation is a recognized basis to challenge a denial.
Are addiction and substance-use treatment covered too?
Yes — the federal law covers both mental-health and substance-use disorder benefits, so addiction treatment must be offered on parity with medical care where the plan provides such benefits. State mandates may expand this. See your state's section above.
Do state parity laws add anything?
Often, yes. Many states require specific benefits, cover plan types the federal law doesn't reach, or enforce parity more actively. Where state law is more protective, it applies. Your state's section above notes its parity statute and mandates.
State-by-state details
Alabama
Primary statute: Alabama Department of Mental Health Act, Ala. Code § 22-50-1 et seq.
Full Alabama guide →Alaska
Primary statute: Alaska Insurance Requirements — Alaska Stat. § 21.42
Full Alaska guide →Arizona
Primary statute: A.R.S. § 20-826.04 — Arizona autism spectrum disorder coverage mandate
Arizona enforces mental health parity through federal law and state-specific behavioral health coverage:
- Arizona follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Arizona Department of Insurance (DOI) enforces parity requirements for state-regulated health plans
- AHCCCS provides behavioral health coverage for Medicaid-eligible individuals, including mental health treatment and substance use disorder services
- Autism coverage is required under Arizona law (A.R.S. § 20-826.04), mandating coverage of behavioral therapy for autism spectrum disorder
- The Arnold v. Sarn consent decree significantly expanded community-based mental health services in Maricopa County
- Arizona requires insurers to cover serious mental illness on the same basis as other medical conditions
Arkansas
Primary statute: Arkansas Mental Health Coverage Requirements, Ark. Code § 23-86-301 et seq.
Arkansas enforces federal mental health parity requirements for insurance plans:
- The federal Mental Health Parity and Addiction Equity Act (MHPAEA) requires insurers to cover mental health and substance use disorder benefits at parity with medical/surgical benefits
- Arkansas adopted the federal parity standard — insurers cannot impose more restrictive limitations on mental health benefits than on medical benefits
- This applies to deductibles, copays, out-of-pocket limits, visit limits, and prior authorization requirements
- Arkansas law (Ark. Code § 23-86-301 et seq.) requires coverage for mental health conditions in state-regulated plans
- If your insurer denies a mental health claim, you have the right to an internal appeal and an independent external review
- The Arkansas Insurance Department enforces parity for state-regulated plans
California
Primary statute: California Health & Safety Code § 1374.72 — Mental Health Parity Act
Full California guide →Colorado
Primary statute: C.R.S. § 10-16-104 — mental health and substance use disorder coverage requirements
Colorado has strong mental health parity requirements that exceed federal law in several areas:
- The federal MHPAEA applies to employer-sponsored and marketplace plans in Colorado
- Colorado's own parity requirements (C.R.S. § 10-16-104) mandate coverage for mental health and substance use disorder treatment on equal terms with medical/surgical benefits
- Colorado requires coverage for autism spectrum disorder treatment (SB 19-088) including applied behavior analysis (ABA)
- The Colorado Behavioral Health Administration (BHA) oversees the state's mental health and substance use services
- Colorado's crisis system includes a statewide behavioral health crisis hotline (1-844-493-8255) and walk-in crisis centers
- The Colorado Division of Insurance enforces parity requirements and investigates consumer complaints
- Colorado expanded Medicaid coverage for behavioral health services, including residential treatment
Connecticut
Primary statute: CGS § 38a-514b — Autism spectrum disorder coverage
Connecticut has strong mental health parity protections exceeding federal requirements:
- Connecticut follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Connecticut Insurance Department actively enforces parity requirements for state-regulated health plans
- Connecticut mandates coverage for autism spectrum disorder treatment (CGS § 38a-514b)
- Connecticut requires insurers to cover a minimum number of mental health outpatient visits per year
- Connecticut's Behavioral Health Partnership coordinates Medicaid behavioral health services
- Connecticut has been a leader in children's mental health services through its DCF and community-based programs
- Parity complaints can be filed with the Connecticut Insurance Department
Delaware
Primary statute: Delaware Mental Health Parity, 18 Del. C. § 3343
Full Delaware guide →District of Columbia
Primary statute: D.C. Mental Health Parity Act, D.C. Code § 31-3171 et seq.
D.C. has strong mental health parity requirements that go beyond federal law:
- D.C. Mental Health Parity Act (D.C. Code § 31-3171 et seq.): Requires health insurers to cover mental health and substance use disorder services on par with medical and surgical benefits — including equal copays, deductibles, and visit limits
- Broad coverage mandate: D.C. requires individual and group health plans to cover a wide range of mental health conditions, including eating disorders, post-traumatic stress, and substance use disorders
- D.C. Department of Behavioral Health (DBH): Provides direct mental health services, crisis intervention, and substance abuse treatment to D.C. residents regardless of ability to pay
- Mental Health Information Act (D.C. Code § 7-1201.01 et seq.): Provides heightened confidentiality protections for mental health records, requiring specific written consent for disclosure
- Emergency mental health services: D.C. provides 24/7 crisis services through the Access Helpline at (888) 793-4357
Florida
Primary statute: Florida Baker Act, Fla. Stat. § 394
Full Florida guide →Georgia
Primary statute: O.C.G.A. § 33-24-44.1 — Autism Spectrum Disorder Coverage
Georgia follows federal mental health parity requirements with some additional state provisions:
- Federal MHPAEA: Georgia follows the federal Mental Health Parity and Addiction Equity Act, which requires equal coverage for mental health and substance use disorders
- Georgia DOI enforcement: The Georgia Department of Insurance enforces parity requirements for state-regulated insurance plans
- Mental Health Reform Act: Georgia's Mental Health Reform Act established standards for behavioral health services
- Autism coverage: Georgia requires insurance coverage for autism spectrum disorder treatment, including applied behavior analysis (ABA) therapy
- Georgia has limited state-specific mental health parity requirements beyond what federal law mandates
Hawaii
Primary statute: Hawaii Substance Abuse Coverage — HRS § 431:10A-118
Hawaii enforces mental health parity through federal law and strong state insurance requirements:
- Hawaii follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Hawaii Insurance Division enforces parity requirements for state-regulated health plans
- Hawaii's Prepaid Health Care Act means most workers have employer-sponsored coverage that must comply with parity
- Hawaii Medicaid (Med-QUEST) provides behavioral health coverage for eligible individuals
- HRS § 431:10A-118 requires insurers to cover alcohol and substance abuse treatment
- Hawaii has invested in community mental health centers across the islands to improve access in both urban and rural areas
Idaho
Primary statute: Idaho Code § 41-3901 et seq. — mental health insurance coverage requirements
Idaho enforces mental health parity through federal law and state insurance requirements:
- Idaho follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Idaho Department of Insurance enforces parity requirements for state-regulated health plans
- Idaho Medicaid provides behavioral health coverage for eligible individuals
- Idaho Code § 41-3901 et seq. requires insurers to provide coverage for mental health conditions consistent with federal parity requirements
- Idaho has a shortage of mental health providers, particularly in rural areas — telehealth services are expanding access
- Idaho's behavioral health system is administered through regional behavioral health boards
Illinois
Primary statute: 215 ILCS 5/370c — Illinois mental health parity insurance requirements
Full Illinois guide →Indiana
Primary statute: Indiana Code § 27-8-5-15 — state mental health parity coverage requirements
Indiana enforces mental health parity through federal law and state insurance requirements:
- Indiana follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Indiana Department of Insurance enforces parity requirements for state-regulated health plans
- Indiana's Medicaid expansion through HIP 2.0 provides behavioral health coverage for eligible low-income residents
- Indiana requires insurers to cover mental health conditions on the same basis as other medical conditions (IC § 27-8-5-15)
- Indiana has invested in crisis intervention services, including the 988 Suicide and Crisis Lifeline
- The Indiana Division of Mental Health and Addiction (DMHA) oversees the state's behavioral health system
Iowa
Primary statute: Iowa Code § 514C.22 — Mental Health Parity
Iowa enforces federal mental health parity and has state-level mental health coverage mandates:
- The federal Mental Health Parity and Addiction Equity Act (MHPAEA) requires insurers to cover mental health and substance use disorder benefits at parity with medical/surgical benefits
- Iowa law (Iowa Code § 514C.22) requires state-regulated plans to provide mental health and substance use disorder coverage consistent with federal parity requirements
- Insurers cannot impose more restrictive limitations on mental health benefits than on comparable medical benefits
- If your insurer denies a mental health claim, you have the right to an internal appeal and an independent external review
- Iowa has expanded Medicaid (Iowa Health and Wellness Plan) which includes mental health and substance use disorder benefits
- The Iowa Insurance Division enforces parity for state-regulated plans
Kansas
Primary statute: K.S.A. § 40-2,105a — Mental Health Insurance Coverage
Kansas enforces mental health parity through federal law and state insurance requirements:
- Kansas follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Kansas Department of Insurance enforces parity requirements for state-regulated health plans
- Kansas requires insurers to provide coverage for mental health conditions (K.S.A. § 40-2,105a)
- Kansas has invested in crisis intervention services, including the 988 Suicide and Crisis Lifeline
- The Kansas Department for Aging and Disability Services (KDADS) oversees the state's behavioral health system
- Kansas has not expanded Medicaid, limiting behavioral health access for low-income residents
Kentucky
Primary statute: KRS § 304.17A-142 — Autism Spectrum Disorder Coverage
Kentucky enforces mental health parity through federal law and state-specific coverage requirements:
- Kentucky follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Kentucky Department of Insurance enforces parity requirements for state-regulated health plans
- Kentucky requires insurers to cover autism spectrum disorder treatment (KRS § 304.17A-142)
- Kentucky Medicaid provides behavioral health coverage through managed care organizations
- Kentucky has expanded access to substance use disorder treatment through Medicaid expansion and the opioid crisis response
- The Tim's Law (2022) strengthened Kentucky's assisted outpatient mental health treatment
Louisiana
Primary statute: Louisiana Mental Health Coverage Mandates, La. R.S. § 22:1043
Louisiana follows federal mental health parity requirements with some additional state provisions:
- Federal MHPAEA: Louisiana follows the federal Mental Health Parity and Addiction Equity Act, requiring equal coverage for mental health and substance use disorders
- LA DOI enforcement: The Louisiana Department of Insurance enforces parity requirements for state-regulated plans
- State mental health mandates: Louisiana requires coverage for serious mental illness and mandates minimum benefits for mental health treatment in group health plans
- Substance abuse coverage: Louisiana requires insurers to provide coverage for substance abuse treatment
- Office of Behavioral Health: The Louisiana Department of Health, Office of Behavioral Health provides public mental health services
Maine
Primary statute: 24-A M.R.S.A. § 2843 — Maine Mental Health Parity Act
Full Maine guide →Maryland
Primary statute: Maryland Mental Health Parity, MD Code, Insurance § 15-802
Full Maryland guide →Massachusetts
Primary statute: MGL c. 175, § 47B — Massachusetts mental health parity requirements
Massachusetts has strong mental health parity requirements that complement and exceed federal law:
- MGL c. 175, § 47B requires comprehensive mental health coverage in all insurance plans, mandating that mental health and substance use disorder benefits be covered at parity with medical/surgical benefits
- MA follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) and was an early adopter of parity requirements before the federal law
- The MA Division of Insurance (DOI) actively enforces parity compliance and conducts regular reviews of insurer practices
- Autism spectrum disorder coverage is required, including applied behavior analysis (ABA) therapy with no dollar caps or age limits
- MA requires coverage for evidence-based treatments for substance use disorders, including medication-assisted treatment
- Insurers cannot impose more restrictive prior authorization, visit limits, or copay requirements on mental health services than on comparable medical services
Michigan
Primary statute: Michigan Mental Health Code, MCL § 330.1001 et seq.
Michigan enforces mental health parity through both federal law and the Michigan Mental Health Code:
- Michigan follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) — insurers cannot impose stricter limits on mental health and substance use benefits than on medical/surgical benefits
- The Michigan Mental Health Code (MCL § 330.1001 et seq.) establishes rights for persons receiving mental health services and governs the community mental health system
- The Michigan Department of Insurance and Financial Services (DIFS) enforces insurance parity requirements for state-regulated plans
- Autism spectrum disorder coverage is required under Michigan law (MCL § 550.1416d) — applied behavior analysis (ABA) therapy must be covered
- Michigan's community mental health system provides services for individuals regardless of ability to pay
- Emergency mental health evaluations and involuntary commitment are governed by the Mental Health Code
Minnesota
Primary statute: Minn. Stat. § 62Q.47 — Mental Health Parity
Minnesota has comprehensive mental health parity requirements that exceed federal law:
- The federal MHPAEA applies to employer-sponsored and marketplace plans in Minnesota
- Minnesota's own parity law (Minn. Stat. § 62Q.47) requires health plans to cover mental health and substance use disorder treatment on equal terms with medical/surgical benefits
- Minnesota requires coverage for children's mental health services and early intervention
- The Minnesota Comprehensive Adult Mental Health Act provides a framework for community-based mental health services
- Minnesota has a statewide mental health crisis system including crisis teams and mobile crisis units available 24/7
- The Minnesota Department of Commerce enforces parity requirements for state-regulated plans
- Minnesota expanded Medicaid (Medical Assistance) coverage for behavioral health services, including residential treatment and community-based programs
Mississippi
Primary statute: Miss. Code Ann. § 83-9-35 — mental health and substance use disorder insurance requirements
Mississippi enforces federal mental health parity requirements for insurance plans:
- The federal Mental Health Parity and Addiction Equity Act (MHPAEA) requires insurers to cover mental health and substance use disorder benefits at parity with medical/surgical benefits
- Mississippi follows the federal parity standard — insurers cannot impose more restrictive limitations on mental health benefits than on medical benefits
- Mississippi has one of the highest rates of uninsured residents and significant mental health care access challenges
- If your insurer denies a mental health claim, you have the right to an internal appeal and an independent external review
- Medicaid in Mississippi (not expanded as of 2024) has limited mental health coverage — this is a significant access gap for many residents
- The Mississippi Insurance Department enforces parity for state-regulated plans
Missouri
Primary statute: Missouri Mental Health Parity, RSMo § 376.1550
Missouri enforces federal mental health parity and has state mental health coverage mandates:
- The federal Mental Health Parity and Addiction Equity Act (MHPAEA) requires insurers to cover mental health and substance use disorder benefits at parity with medical/surgical benefits
- Missouri law (RSMo § 376.1550) requires state-regulated health insurance plans to provide coverage for mental health conditions
- Insurers cannot impose more restrictive limitations on mental health benefits than on comparable medical benefits
- If your insurer denies a mental health claim, you have the right to an internal appeal and an independent external review (RSMo § 376.1367)
- Missouri has expanded Medicaid (MO HealthNet) which includes mental health and substance use disorder benefits
- The Missouri Department of Insurance, Financial Institutions and Professional Registration enforces parity for state-regulated plans
Montana
Primary statute: Mont. Code Ann. § 33-22-706 — mental health insurance mandates
Full Montana guide →Nebraska
Primary statute: Neb. Rev. Stat. § 44-791 — Mental Health Insurance Coverage
Nebraska enforces mental health parity through federal law and state insurance requirements:
- Nebraska follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Nebraska Department of Insurance enforces parity requirements for state-regulated health plans
- Nebraska Medicaid (Heritage Health) provides behavioral health coverage for eligible individuals
- Nebraska requires insurers to cover treatment for serious mental illness on the same basis as other medical conditions (Neb. Rev. Stat. § 44-791 et seq.)
- Nebraska's Division of Behavioral Health oversees community-based mental health services statewide
- Nebraska has invested in behavioral health regions to provide accessible treatment across rural areas
Nevada
Primary statute: NRS 689A.0435 — Autism Spectrum Disorder Coverage
Nevada enforces mental health parity through federal law and strong state-level behavioral health requirements:
- Nevada follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Nevada Division of Insurance enforces parity requirements for state-regulated health plans
- Nevada Medicaid provides behavioral health coverage for eligible individuals, including mental health treatment and substance use disorder services
- Nevada has enacted laws requiring coverage of autism spectrum disorder treatment (NRS 689A.0435)
- Nevada has addressed its mental health provider shortage through telehealth expansion and incentive programs
- Insurers must cover serious mental illness on the same basis as other medical conditions
New Hampshire
Primary statute: RSA 417-E:1 — NH Mental Health Parity Act
Full New Hampshire guide →New Jersey
Primary statute: NJ autism insurance coverage mandate, N.J.S.A. 17B:27A-19.31
Full New Jersey guide →New Mexico
Primary statute: NMSA § 59A-23E-18 et seq. — mental health coverage requirements
New Mexico enforces mental health parity and has invested significantly in behavioral health services:
- New Mexico follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The New Mexico Office of Superintendent of Insurance enforces parity requirements for state-regulated health plans
- New Mexico Medicaid provides behavioral health coverage for eligible individuals, including mental health treatment and substance use disorder services
- New Mexico has enacted requirements for coverage of substance use disorder treatment, addressing the state's opioid crisis
- The Behavioral Health Services Division oversees community-based mental health services statewide
- New Mexico has expanded telehealth services for mental health, which is critical for its large rural population
New York
Primary statute: NY Insurance Law § 3221(l)(5) — Timothy's Law mental health parity
Full New York guide →North Carolina
Primary statute: N.C. Gen. Stat. § 58-3-190 — Autism spectrum disorder coverage mandate
North Carolina requires mental health parity in insurance coverage, following both federal and state mandates:
- NC follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA), which requires insurers to cover mental health and substance use disorder benefits at parity with medical/surgical benefits
- The NC Department of Insurance (DOI) enforces parity requirements for state-regulated health plans
- NC has the Mental Health, Developmental Disabilities, and Substance Abuse Act (N.C. Gen. Stat. Ch. 122C) governing the state mental health system
- Autism spectrum disorder coverage is required under NC law (N.C. Gen. Stat. § 58-3-190), including applied behavior analysis (ABA) therapy
- Insurers cannot impose stricter limits (higher copays, fewer visits, more restrictive preauthorization) on mental health services than on comparable medical services
- NC Medicaid covers mental health and substance abuse treatment services
North Dakota
Primary statute: N.D. Cent. Code § 26.1-36 — Health Insurance Requirements
Full North Dakota guide →Ohio
Primary statute: Ohio Rev. Code § 3922.48 — required insurance coverage for autism spectrum disorder
Ohio follows federal mental health parity requirements and has additional state-level provisions:
- Federal MHPAEA: Ohio insurers must comply with the federal Mental Health Parity and Addiction Equity Act, requiring equal coverage for mental health and substance use disorders
- Ohio Department of Insurance: Enforces parity requirements for state-regulated insurance plans
- Ohio Mental Health and Addiction Services (OhioMHAS): The state agency overseeing Ohio's mental health and addiction services system, providing funding and oversight for community-based services
- Autism coverage (ORC § 3922.48): Ohio requires insurance coverage for autism spectrum disorder, including applied behavior analysis (ABA) therapy
- Ohio Medicaid also covers mental health and substance use disorder services
Oklahoma
Primary statute: Oklahoma Insurance Code, Okla. Stat. tit. 36
Oklahoma enforces mental health parity through federal law and state requirements:
- Oklahoma follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Oklahoma Insurance Department enforces parity requirements for state-regulated health plans
- Oklahoma requires insurers to cover substance abuse treatment and has expanded access through Medicaid expansion (SQ 802)
- Oklahoma has been significantly impacted by the opioid crisis and has invested heavily in addiction treatment infrastructure
- The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) oversees state behavioral health services
- Oklahoma Medicaid provides behavioral health coverage through managed care
Oregon
Primary statute: Oregon Mental Health Parity Act — ORS § 743A.168
Oregon has comprehensive mental health parity requirements with robust enforcement:
- The federal MHPAEA applies to employer-sponsored and marketplace plans in Oregon
- Oregon's own parity law (ORS § 743A.168) requires health plans to cover mental health and substance use disorder treatment on equal terms with medical/surgical benefits
- Oregon mandates coverage for substance use disorder treatment including medication-assisted treatment (MAT)
- Oregon Parity Act (SB 860, 2017): Enhanced parity enforcement requiring insurers to submit annual parity compliance reports to the Oregon Department of Consumer and Business Services
- Oregon's behavioral health crisis system includes 988 crisis lines, community mental health centers, and mobile crisis teams
- The Oregon Division of Financial Regulation enforces parity requirements and investigates consumer complaints
- Oregon expanded Medicaid (OHP) coverage for behavioral health services, including community-based and residential treatment
Pennsylvania
Primary statute: Pennsylvania Mental Health and Intellectual Disabilities Act, 50 P.S. § 7101
Full Pennsylvania guide →Rhode Island
Primary statute: R.I. Gen. Laws § 27-38.2 — Rhode Island Mental Health Parity Act
Full Rhode Island guide →South Carolina
Primary statute: S.C. Code § 38-71-280 — Alcohol and Drug Abuse Coverage
South Carolina follows federal mental health parity requirements with some additional state provisions:
- Federal MHPAEA: SC follows the federal Mental Health Parity and Addiction Equity Act, requiring equal coverage for mental health and substance use disorders
- SC DOI enforcement: The SC Department of Insurance enforces parity requirements for state-regulated plans
- SC Mental Health Law: SC has a state mental health system under the SC Department of Mental Health
- Alcohol and drug abuse coverage: SC requires insurers to offer coverage for alcohol and drug abuse treatment
- SC has limited state-specific parity requirements beyond federal law
South Dakota
Primary statute: SDCL Ch. 27A-1 — Mental Health Commitment
Full South Dakota guide →Tennessee
Primary statute: TCA § 56-7-2360 — Mental Health Insurance Coverage
Full Tennessee guide →Texas
Primary statute: Texas SUD Coverage Requirement, Tex. Ins. Code Ch. 1355
Full Texas guide →Utah
Primary statute: Utah Mental Health Insurance Coverage — Utah Code § 31A-22-625
Utah enforces mental health parity through federal law and state behavioral health requirements:
- Utah follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The Utah Insurance Department enforces parity requirements for state-regulated health plans
- Utah's Medicaid expansion provides behavioral health coverage for eligible low-income residents
- Utah requires insurers to cover mental health conditions on the same basis as other medical conditions
- Utah has invested in crisis intervention services, including the 988 Suicide and Crisis Lifeline and statewide mobile crisis teams
- Utah's substance abuse treatment system operates through local substance abuse authorities under the Division of Substance Abuse and Mental Health
Vermont
Primary statute: 8 V.S.A. § 4089b — Vermont Mental Health Parity Act
Full Vermont guide →Virginia
Primary statute: Virginia Mental Health Law, Va. Code § 37.2 et seq.
Virginia follows federal mental health parity requirements and adds state-specific coverage mandates:
- Virginia insurers must comply with the federal Mental Health Parity and Addiction Equity Act (MHPAEA), ensuring mental health benefits are no more restrictive than medical/surgical benefits
- The Virginia State Corporation Commission (SCC) Bureau of Insurance enforces parity requirements for state-regulated insurance plans
- Virginia Mental Health Law (Va. Code § 37.2) governs mental health services, involuntary commitment, and patient rights
- Virginia requires coverage for autism spectrum disorder, including applied behavior analysis (ABA), under Va. Code § 38.2-3418.17
- Virginia mandates coverage for applied behavior analysis (ABA) for individuals diagnosed with autism through age 18 (or beyond if medically necessary)
- Substance use disorder treatment must be covered on par with other medical conditions
Washington
Primary statute: Washington Mental Health Parity Act, RCW 48.44.341
Washington enforces mental health parity through both federal and strong state law:
- The federal Mental Health Parity and Addiction Equity Act (MHPAEA) applies to Washington employer-sponsored and marketplace plans
- Washington's Mental Health Parity Act (RCW 48.44.341) requires insurers to cover mental health and substance use disorder services on equal terms with medical/surgical benefits
- The Washington Office of the Insurance Commissioner (OIC) actively enforces parity requirements
- Washington requires broad mental health coverage including outpatient therapy, inpatient treatment, and substance abuse services
- Autism coverage is required under Washington law for state-regulated health plans
- Washington has a strong community mental health system with state-funded services for uninsured and underinsured residents
- Denial of mental health claims can be appealed through the OIC
West Virginia
Primary statute: W. Va. Code § 33-16-3a — Mental health coverage
West Virginia enforces mental health parity with significant focus on substance use disorder treatment:
- West Virginia follows the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requiring equal coverage for mental health and substance use disorders
- The West Virginia Offices of the Insurance Commissioner enforces parity requirements for state-regulated health plans
- West Virginia Medicaid provides behavioral health coverage for eligible individuals, including mental health treatment and substance use disorder services
- West Virginia has enacted specific legislation addressing its opioid crisis — expanded access to substance use disorder treatment is a state priority
- The WV Department of Health and Human Resources oversees community-based mental health services
- West Virginia has expanded telehealth services for mental health, critical for its large rural population with limited provider access
Wisconsin
Primary statute: Wis. Stat. § 632.89 — Mental Health and Substance Use Disorder Parity
Wisconsin enforces federal mental health parity and has state-level mental health coverage mandates:
- The federal Mental Health Parity and Addiction Equity Act (MHPAEA) requires insurers to cover mental health and substance use disorder benefits at parity with medical/surgical benefits
- Wisconsin law (Wis. Stat. § 632.89) requires state-regulated plans to provide mental health and substance use disorder coverage and comply with parity requirements
- Insurers cannot impose more restrictive limitations on mental health benefits than on comparable medical benefits
- If your insurer denies a mental health claim, you have the right to an internal appeal and an independent external review (Wis. Stat. § 632.835)
- Wisconsin Medicaid (BadgerCare Plus) covers mental health and substance use disorder services
- The Wisconsin Office of the Commissioner of Insurance enforces parity for state-regulated plans
Wyoming
Primary statute: Mental Health Parity and Addiction Equity Act, 29 U.S.C. § 1185a
Full Wyoming guide →