Definition


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Parity is about fairness. Americans with behavioral health conditions often have more difficulty getting the treatment and services they need when compared to individuals seeking other medical care. Explore parity-related information regarding legislation, statutes, and regulatory actions since the Federal Parity Law was passed in 2008.

Arizona Parity Law

There is a section in the state insurance law relevant to parity and several sections about coverage for autism services.

Mental Health Coverage

This section of the insurance law applies to mental health services and explicitly does not apply to substance use disorder services. This section only applies to large employer fully-insured plans.

Plans are not required to cover mental health services, but if they do, the following is required regarding annual maximums and lifetime maximums:

  • They are not allowed if they are not in place for most other medical services
  • The annual maximum and lifetime maximum for mental health services must be the same as the ones for other medical services

OR

  • Mental health services and other medical services count towards the same annual maximum and lifetime maximum

There is nothing in this section of the law that addresses treatment limitations or other financial requirements .

Autism Coverage

There are four sections of the insurance law about coverage for autism services. They can be found hereherehere, and here.

These sections only apply to large employer fully-insured plans. Plans cannot use different deductibles or coinsurance for autism services.

Plans must cover $50,000 of “behavioral therapy” each year for children through age 8, and $25,000 for children age 9 through 16. “Behavioral therapy” includes applied behavior analysis.

Autism Spectrum Disorder is defined as autistic disorder, Asperger’s syndrome, and pervasive developmental disorder not otherwise specified.

State Parity Reports

View the state parity reports to learn about legislation, regulation, and litigation related to parity implementation

State Parity Reports

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Common Violations

In seeking care or services, be aware of the common ways parity rights can be violated.