Timothy's Law requires health policies to include coverage for the diagnosis and treatment of mental, nervous, or emotional disorders for up to 30 days of inpatient care and 20 days of outpatient care in a calendar year. Any deductible, copayments, or coinsurance applied to the Timothy's Law benefits can be no greater than those applied to other benefits under your contract. Most members' contracts already include coverage for 30 days inpatient/20 days outpatient care; the change you may notice is in your out-of-pocket cost for these benefits, which may change to comply with the law.
Based on whether your employer is a large group or small group will determine whether your benefits also include coverage for the treatment of biologically-based conditions, such as schizophrenia/psychotic disorder, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorder, bulimia, and anorexia.
If you are covered under a policy or contract issued to a large employer group (the employer has more than 50 employees eligible for health coverage), the group must provide these benefits. If your employer is a small group employer (50 or fewer eligible employees), your employer may choose to provide these benefits.