Behavioral health is an essential part of overall health. That’s why we want to assure CalPERS health plan members: your access to behavioral health services remains protected, even as changes unfold at the federal level.
On Friday, May 9, the federal government signaled that it will no longer enforce expanded mental health parity rules finalized under President Biden’s administration. These rules were designed to strengthen federal enforcement of health insurers providing behavioral health care on equal footing with medical and surgical care — an approach known as mental health parity.
“While this shift in enforcement could affect health plans across the country, CalPERS members are secure from many of the potential impacts,” said CalPERS Chief Health Director Don Moulds. “Thanks to the standards we uphold through our contracts with our health plans and California’s strong parity protections, we remain committed to ensuring our members can access quality behavioral health services.”
The Promise of Parity
Mental health parity means that health plans approach mental health and substance use disorder benefits in the same way that they approach physical health care. This includes alignment on costs, treatment, and access to ensure that members receive timely and comprehensive care for their behavioral health needs.
How Are CalPERS Benefits Protected?
CalPERS contracts with health plans that are required to comply with California laws, which go beyond federal parity rules in several important ways.
Under these laws and our contractual requirements, health plans are required to:
- Cover mental health and substance use disorders when medically necessary.
- Ensure timely access to care, including non-urgent appointments within 10 business days.
- Maintain behavioral health provider networks and transparent appeal rights.
These protections (PDF) remain in effect regardless of federal enforcement changes.
What this means for you: Even if the federal government weakens its oversight, your CalPERS benefits — and your access to behavioral health care — remain protected.
What Services Are Available to You?
Through your CalPERS health plan, you have access to a broad array of behavioral health services. These services include:
- Individual, group, and family therapy
- Psychiatric evaluation and medication management
- Inpatient and outpatient treatment for mental health and substance use disorders
- Virtual behavioral health services
While increases in demand for behavioral health services and a shortage of providers continue to pose challenges statewide, CalPERS has added new requirements to their health plan contracts intended to expand and improve access to these services.
For more information, we encourage members to review their plan’s Evidence of Coverage booklet or call their health plan for guidance on how to access services.
Our Commitment to You
CalPERS remains steadfast in its commitment to provide access to equitable, affordable, and high-quality behavioral health care for all members. We are proud to operate in a state with some of the nation’s strongest mental health parity protections — and we will continue to work with partners to provide the care our members deserve.
Federal guidelines are changing but our promise to you is not.
If you have questions about your behavioral health benefits, reach out to your health plan or contact CalPERS at 888 CalPERS (or 888-225-7377).