Federal

The major federal laws that protect your rights to get equal access to your mental health and substance use disorder benefits are:

• The Mental Health Parity and Addiction Equity Act (MHPAEA)
• Patient Protection and Affordable Care Act

These laws apply to most health insurance plans.

New York State

NYS also has laws that enhance coverage and promote access to behavioral health services, including:

• Timothy’s Law
• NYS Mental Health and Substance Use Disorder Parity Reporting Act

NYS laws only apply to insurance products regulated by NYS. NYS-regulated Plans are listed on the Department of Financial Services website:

• DFS Insurance Company Search

What Do These Laws Do?

In combination, these New York State and federal laws require most comprehensive health insurance plans to cover medically necessary mental health services. Plans must manage your mental health or substance use benefits as they manage medical and surgical benefits, without additional limitations.

This means that insurance plans are forbidden to require you to “fail first” at a lower level of care before they cover treatment recommended by your doctor or therapist, such as inpatient hospitalization.