Behavioral Health: Benefits & Covered Services

The Behavioral Health Plan covers a wide range of services to assist you and your family members.  If you have had a major loss or trauma in your life, adjusting to that may be significantly helped by counseling.  Individual, marital, and family problems deserve professional help.  Treating such problems can reduce stress that posses a risk to your physical health.

All services must be pre-authorized by the Employee Assistance Program (EAP).  There is no coverage for treatment not pre-authorized through the EAP or that is in excess of the plan’s limitations.  It is your responsibility to understand and keep track of the benefits available to you.  Payments are made on the basis of Maximum Allowable charges and/or pre-negotiated rates.

Pre-Authorization is based upon current eligibility, plan benefits and maximums which are subject to change and therefore are not a guarantee of payment.

	In-Network	Out-of-Network
Inpatient Services Residential Program Professional Charges Detoxification Services 30 Day Limit per year	100%	80%
Halfway House Services Professional Charges 60 Day Limit per year	100%	80%
Day Treatment Programs Professional Charges 60 Day Limit per year	100%	80%
Structured Outpatient Services Intensive Outpatient Programs	100%	80%
Outpatient Services 30 Visit Limit per year	70%	40%