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Insurance & Parity Rights

Federal law — MHPAEA

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans to cover behavioral health benefits at parity with medical/surgical benefits. This is in force.

Important current context: On May 15, 2025, the U.S. Department of Labor announced non-enforcement of the 2024 MHPAEA Final Rule pending resolution of the ERIC lawsuit (ongoing, expected 18+ months). The underlying 2013 regulations and the 2021 Non-Quantitative Treatment Limit (NQTL) comparative-analysis statutory obligation remain fully in force. Your federal parity rights are in place; enforcement of the newer rule is paused.

File a complaint: DOL EBSA (ERISA plans).

Indiana state law — IC 27-13-44.5

Indiana's parity statute (Indiana Code 27-13-44.5) applies to HMO and PPO plans regulated by the state. It provides additional enforceable protections through the Indiana Department of Insurance.

File a complaint: Indiana Department of Insurance.

Healthy Indiana Plan (HIP) — Medicaid

Indiana Medicaid (Healthy Indiana Plan) covers behavioral health services for eligible adults. Coverage includes outpatient therapy, medication management, SUD treatment, and crisis services. Find HIP-accepting providers via SAMHSA filtered to "accepts Medicaid."

HIP enrollment: in.gov/fssa/hip.

988 access — always free

988 itself is free regardless of insurance. If 988 connects you to follow-up care, your insurance plan (commercial / HIP / Medicare) may bill for that follow-up under standard rules.

Sliding scale + charity care

Many community providers (including Aspire Indiana Health) offer sliding-scale fees based on income. Federally Qualified Health Centers (FQHCs) and some hospital systems are required to offer charity care under Indiana Code 12-15-2 to qualifying low-income residents. Always ask — charity care is often not advertised but available on request.

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