Medicaid and Mental Health Parity Act


Medicaid is a kind of public health insurance that targets the low-income individuals or families that cannot afford to seek medical help. State and federal funding regulate Medicaid.  Medicaid pays the service providers directly- doctors, hospitals, nursing facilities, clinics, psychotherapists, adult medical day cares and others. Medicaid also provides limited or optional services such as prescription drugs, dental and vision care.

Additionally, Medicaid offers the elderly long-term care and acts as a supplementary benefit for low-income Medicare beneficiaries.

Majority of the low-income population are qualified to avail of Medicaid health services; however, their requirements that must be met. Some of these requirements include age, gender, if pregnant or disabled. Income and other resources such as bank account, real estate and other properties that can be sold for cash need to be declared when applying for eligibility. These rules or requirements vary from state to state.

Medicaid also provides a broad coverage or benefits for mental health, much more than what the private insurance company provides. Generally, health care insurance providers have limited coverage when it comes to mental health benefits.

Application literature and forms to avail Medicaid services are available in the local health department office. It can also be downloaded online, however, application may only be submitted through mail, fax or in person.

Mental Health Parity Act

The discrepancy between medical/surgical health coverage or benefit and mental health benefits greatly varies. This is the main argument that mental health advocates are vocal about. And thus, the mental health parity act law was enacted.

Mental Health Parity Act prohibits insurers and healthcare providers from discriminating between benefits or coverage offered for mental illness (serious or otherwise) and physical diseases or illnesses. They should provide the same level of financial and treatment coverage that they offer for physical illnesses. These benefits include but are not limited to deductibles, copayments, lifetime and annual limits. Again, the mental health parity act law varies from state to state. Some states may offer broader mental health coverage while others limit coverage to serious mental illnesses or biologically based illnesses.

It should be understood, though, that the Mental Health Parity Act does not require group health plans to provide mental health benefits. It also does not apply to small group health plans or to those who are under health insurance coverage in the individual, non-employment market.

What is the relationship between Medicaid and Mental Health Parity Act? Medicaid Managed Care Plans, being a public healthcare plan, should also provide the same level of benefits they offer for medical and mental health. The deductibles, copayments and daily visits should not be restrictive for mental illness than for coverage of medical and surgical treatment.

For more information about Medicaid and Mental Health Parity Act, consult your local health department for your state’s Medicaid program.