Fast Fact: ALL ACA-Compliant Health Insurance Plans MUST Contain Mental Health Benefits

Here’s a fast-fact for you on 2018 Mental Health Awareness Day: ALL ACA-compliant health insurance plans MUST contain mental health benefits. That’s a fact. 

Healthcare reform (a.k.a. Obamacare, a.k.a. the Affordable Care Act) required that “qualified health insurance plans” MUST contain “essential health benefits.” One of these essential health benefits is: access to mental healthcare.

Here’s what you should know about which health plans MUST contain mental health benefits:

  • Individual & Family Plans: if you purchase an ACA individual/family plan from the health insurance marketplace, or directly from an insurance company, these plans MUST contain mental health benefits.
  • Small Employer Health Plans: nearly all small employer plans usually contain mental health benefits. The size of a small employer is defined state-by-state. Many states recognize a small employer as a company with less that 50 full time equivalent employees. Some states recognize a small employer as a company with less than 100 full time equivalent employees.
  • Large Employer Health Plans: large employer health plans (usually employers with over 100 employees) are not required to contain mental health benefits, however MOST do. Make sure to do some research into your plan, to see what kind of mental health benefits are included.
  • Self Funded Health Plans: self funded health plans are NOT required to contain mental health benefits, but again, MOST of them do. Self funded plans are most typically provided by large (to very large) employers (examples: state employees, hospitals, very large corporations, etc). If you have a self funded plan, make sure to check whether-or-not you have access to mental health benefits.

In conclusion, mental health benefits can be IMPORTANT. There is a reason that they are contained in MOST health insurance plans. On Mental Health Awareness Day, we want to raise awareness that you most likely have access to these kinds of important “essential benefits.” For questions regarding individual and employer health insurance in the state of California, contact us anytime. 

Thanks for stopping by, we hope you found our information to be helpful. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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