Mental Health Insurance Coverage

Consumer protections for mental health insurance coverage 

The Minnesota Department of Commerce works to enforce state and federal laws for “mental health parity” that require insurance coverage for mental health care to not be more restrictive than coverage for other medical care.  

What does mental health parity mean for me? 

Mental health parity helps Minnesotans access the mental health and substance use disorder care they need. Generally, mental health plans should not impose: 

• Higher coinsurance, copays and deductibles for mental health and substance use disorder care, compared to physical health care. 
• Stricter limits on the number of visits for outpatient mental health and substance use disorder care, compared to physical health care. 
• Prior authorization requirements for mental health and substance use disorder care that are more restrictive than those for physical health care. 

How does Commerce support mental health parity? 

• Mental health insurers submit a description of the treatments and services they will cover to Commerce and the Department of Health (MDH) every year. We review these submissions to ensure that mental health parity is reflected in the mental health plans being offered to Minnesotans. 
• Minnesota state law requires Commerce and MDH to produce an annual report that reviews compliance, oversight, and enforcement of mental health parity laws over the previous year.  
• Commerce takes a variety of actions to determine if insurers are violating parity laws to ensure enforcement of the laws, including:  
  • Review of complaints from consumers and providers to assess whether an insurance carrier is complying with parity requirements 
  • Education for consumers and providers to help identify if their insurance carrier is not following parity laws
  • Close monitoring of the insurance company by Commerce 
  • Imposing a fine as a last resort enforcement action  

What should I do if my mental health or substance use claim was denied?

If an appeal to the insurance carrier is still denied, you can file an external review.

Contact the Mental Health Parity Office

Parity.Enforcement.COMM@state.mn.us