The Mental Health Parity and Addiction Equity Act requires group plans to:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Mental health parity means that the financial requirements (deductibles, copays, coinsurance, and out-of-pocket limits) and treatment limitations (visit limits, day limits, and prior authorization requirements) applied to mental health and substance use disorder benefits cannot be more restrictive than those applied to comparable medical and surgical benefits. The law does not require plans to offer mental health coverage in the first place, but if they do, the terms must be equal. Insurers may still manage care and use utilization review, so the parity obligation is one of comparability, not a mandate of unlimited or free coverage.
Why the other options are wrong
- B) Parity is about equal treatment limits and cost sharing, not a mandate to cover every proposed treatment at 100%. Plans may still apply copays, deductibles, and utilization management to mental health care.
- C) Parity laws do not eliminate mental health benefits; they protect them from being subjected to harsher financial or treatment terms than other medical benefits.
- D) Insurers may use visit limits, but only if comparable limits apply to medical and surgical benefits. A mental-health-only fixed cap that is stricter than the medical standard would violate parity.
Memory hook
Parity = mental health gets the same rules as heart surgery, not stricter ones.