Real Care Means Real Access
New York State has strengthened protections to ensure New Yorkers with qualifying insurance plans can access mental health and substance use disorder services (together known as behavioral health services) without unreasonable delays. As of July 2025, there are new rules that some New York State health insurers must follow when providing behavioral health services:
- Offer timely appointments
- Help you find in-network providers
- Cover out-of-network care at no extra cost when in-network care isn't available
Your Rights: What Real Care Means for You
Learn more about your rightsTimely Appointments
You are entitled to see a mental health or substance use provider within 10 business days for initial outpatient visits, or 7 calendar days for a follow-up after being discharged from a hospital or emergency room.
Help Finding Providers
Insurers must have dedicated employees who can help you find an in-network mental health or substance use provider within a reasonable timeframe. Information on how to contact these employees must be available on your insurer’s website.
Out-of-Network Care
When in-network behavioral health care is not available in a reasonable timeframe, you won't have to pay more for out-of-network behavioral health care.
Who Qualifies for These Protections?
These rules apply to the following insurance plan types:
- Individuals and groups with fully insured comprehensive health insurance (individual and group markets)
- Medicaid Managed Care beneficiaries
- Enrollees in other government-sponsored health plans, including Child Health Plus (CHP) and Essential Plan (EP)
- Qualified Health Plan (QHP) enrollees
- New York State Health Insurance Program (NYSHIP) enrollees
- Municipal Cooperative Health Benefit Plans
These rules do not apply to self-funded Employee Retirement Income Security Act (ERISA) plans.
Different rules apply for Medicare. For more information, call the Medicare Rights Center at (800) 333-4114 or visit www.medicarerights.org.