What was denied
Mental health and substance use care
Therapy, residential and intensive programs, and using the parity law in an appeal.
Do this today
- Use the tool: Mental health parity self-check See whether your mental health or substance use denial raises a parity question, and get the request to send.
- Read: Level-of-care denials 5 minute read. Your plan says you no longer need the level of mental health or substance use care you are in, such as residential or inpatient treatment. Here is how to keep care going while you appeal.
-
Put this step on My Plan
So you can come back to it, and keep your dates and calls in one place.
In brief
- A level-of-care denial says you do not need this setting, such as residential or inpatient care, and could be treated somewhere less intensive. Plans often send these while you are already in treatment.
- Ask for an urgent appeal and for the plan's written criteria on the same day. Ask your treating clinician to speak with the plan's reviewer.
- Level of care is a medical-judgment question, so a final denial can go to independent external review, and an urgent one can be reviewed fast.
More guides, tools and letters
More guides, tools, letters 10
Guides
- Level-of-care denials
Your plan says you no longer need the level of mental health or substance use care you are in, such as residential or inpatient treatment. Here is how to keep care going while you appeal.
- Mental health and substance use denials: using the parity law
How to use the federal parity law when appealing a mental health or substance use denial. Learn which documents to demand and what is and is not being enforced as of 11 November 2026.
Tools
- Tool
Mental health parity self-check
See whether your mental health or substance use denial raises a parity question, and get the request to send.
Letters and scripts
- Letter or script
Appeal: mental health or substance use care with a parity argument
Asks your plan to reverse a mental health or substance use denial and to produce its criteria and comparative analysis under the federal parity law.
- Letter or script
Ask for the parity comparison for a mental health denial
A written request for the plan's mental health parity comparison and the medical necessity criteria behind a mental health or substance use denial, so you can test the decision against the parity law.
Denial reasons
- Denial reason
Level of care
Your plan agrees you need treatment but says a less intensive setting would do. For example, outpatient care instead of residential care, or a lower-intensity program instead of a hospital stay.
Programs and services
- Program or service
Legal Action Center free legal help in New York
Free legal help for New Yorkers with substance use disorders or mental health care needs, including insurance barriers to treatment. Nationwide help is limited to certain addiction-medication cases.
From Legal Action Center
- Program or service
National Alliance on Mental Illness guide to insurance denials
A plain explanation of why mental health care is denied, five signs of a possible parity violation, and a link to a longer appeals guide written with The Kennedy Forum. Information only.
From National Alliance on Mental Illness
- Program or service
National Alliance on Mental Illness HelpLine
A free, confidential helpline for mental health information, support and resources. It does not do individual advocacy or casework, so it will not fight a denial for you. In a crisis, call or text 988.
From National Alliance on Mental Illness
- Program or service
Parity Registry appeal support for mental health and addiction care
A step-by-step guide to fighting a denial of mental health, eating disorder or addiction care under the federal parity law, with a complaint registry and a place to share your story. It does not file appeals for you.
From The Kennedy Forum
Questions to keep handy
- What exactly was denied, and under which part of the plan?
- What is my deadline, and what is it counted from?
- Where and how do I send my request, and how will I prove it arrived?
- Who decides, and can I ask for a faster decision?
Not what you need? Find a person who can help, or search the whole site.