What is mental health parity?

Mental health parity means equal coverage for health care. It requires your mental health coverage to be equal to or better than what it would be for similar medical and surgical coverage.

Before mental health parity laws, health plans could charge higher costs for mental health services than physical health services, or they could limit the number of visits allowed in a year for mental health.

Parity applies to both cost of treatment and how treatment is managed for mental health services:

Examples of cost of treatment

  • Copayments
  • Coinsurance
  • Deductibles
  • Out-of-pocket expenses

Examples of how treatment is managed

  • Prior authorization requirements
  • Not covering certain types of services
  • Access to medications
  • Number of visits covered

Not sure what some of these terms mean? Take a look at our glossary of health coverage terms for handy explanations.

Mental health parity

What parity means for you

We cover medically necessary treatment of mental health disorders and substance use disorders for all of our members.

Log in to Sharp Connect and take a look at your latest Summary of Benefits and Member Handbook. Both of these resources will have more details about how your plan covers behavioral health services.

You don’t need a referral from your primary care doctor to get access to behavioral health services. However, only services offered through plan providers will be covered, unless approved by Sharp Health Plan.

Find out more about your behavioral health coverage

If you’re not sure or if you have questions about what type of coverage you have, call our Customer Care team at 1-858-499-8300 or contact your human resources department.

If you have questions or a complaint related to coverage for behavioral health conditions, give us a chance to help. Our Customer Care team is available to assist you Monday through Friday, 8 am to 6 pm at 1-858-499-8300. Or you can file a formal complaint with a grievance form online at any time.

Remember, we’re here to ensure that you have the best health care experience possible.

To learn more about the federal and state mental health parity laws, we recommend checking out these handouts from the Substance Abuse and Mental Health Services Administration and the Department of Managed Health Care.