Principles for the Provision of Mental Health and Substance Abuse Treatment Services

Benefits

If you have not already received information about your health plan, ask your benefits manager for a copy of your health plan benefits; you have a right to have one of your own to keep. Does this document describe what mental health care and substance abuse treatment benefits you are entitled to? Does it explain how to get services and how to appeal coverage decisions you do not agree with? Does it explain what your financial responsibilities are? Is the coverage equal to that offered for other illnesses?

Individuals have the right to be provided information from the purchasing entity (such as the employer or union or public purchaser) and the insurance/third party payer describing the nature and extent of their mental health and substance abuse treatment benefits. This information should include details on procedures to obtain access to services, on utilization management procedures, and on appeal rights. The information should be presented clearly in writing with language that the individual can understand.