Summary: Medicaid Alternative Benefit Plans
As of 2014, most individual and small group health insurance plans, including plans sold on the Marketplace are required to cover mental health and substance use disorder services. Medicaid Alternative Benefit Plans also must cover mental health and substance use disorder services. These plans must have coverage of essential health benefits, which include 10 categories of benefits as defined under the health care law. One of those categories is mental health and substance use disorder services. Another is rehabilitative and habilitative services. Additionally, these plans must comply with mental health and substance use parity requirements, as set forth in MHPAEA, meaning coverage for mental health and substance abuse services generally cannot
be more restrictive than coverage for medical and surgical services. Under the ACA, millions of low-income people and their children will have access to Medicaid coverage.
be more restrictive than coverage for medical and surgical services. Under the ACA, millions of low-income people and their children will have access to Medicaid coverage.