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Texas Department of Insurance
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How to get help with a mental health issue

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If your health plan covers mental health issues, the law requires it to give the same level of benefits, such as the number of office visits, as it does for a physical illness or injury. This is known as mental health parity. Here’s what else you should know about parity and getting help.

  1. Equal treatment

    The goal of parity is to make it easier to get mental health care. That includes treatment for behavioral health issues and substance use disorders. For example, health plans must have enough in-network doctors and providers for routine and emergency care of behavioral health issues.

  2. If a claim is denied

    It can be hard to tell if a denial of care is a parity issue. If your mental health claim is denied, always ask why. Your health plan will have a process to review and appeal denied claims. You can use this form to ask for more details.

  3. Next steps

    If the health plan’s appeal process didn’t solve your problem, you can also ask for an external review. An independent third party will review your case, and your health plan must honor the decision it makes. External reviews are free to you.

  4. Help is available

    Mental health parity is complicated but finding help shouldn’t be.

Resources

 

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Last updated: 8/10/2022