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The following information applies to services on or after January 1, 2008.
This benefit covers treatment for neuropsychiatric, mental, and personality disorders, including eating disorders. Treatment may be outpatient or inpatient (at a hospital or other facility). Services for mental health disorders are covered under the mental health benefit, no matter what the cause is (such as postpartum depression).
UMP covers up to 50 outpatient mental health visits per calendar year (see definition of "Limited Benefit").
Inpatient mental health services must be preauthorized by UMP.
When your provider prescribes biofeedback therapy for a mental health condition, it is covered under the mental health benefit and is subject to the same limits. See "Does UMP cover biofeedback therapy?" for coverage when biofeedback is prescribed for a physical diagnosis.
Approved Provider Types for Mental Health Services
Mental health treatment must be provided by one of the following provider types:
- Licensed community mental health agency
- Advanced registered nurse practitioner (ARNP), licensed
- Licensed physician
- Licensed psychologist
- Licensed Master of Social Work, Licensed Mental Health Counselor, or Licensed Marriage and Family Therapist
- Licensed hospital
Limitations on Some Provider Types
UMP covers services of a licensed marriage and family counselor only when provided to treat neuropsychiatric, mental, or personality disorders. UMP does not cover marriage or family counseling.
UMP does not cover services provided by registered counselors. (UMP covers only licensed mental health care providers. A registered counselor is not the same as a licensed counselor.)
Services by non-PhD psychologists are covered only when the provider is employed by and delivers services within a licensed community mental health agency and the agency bills for his or her services.
Mental Health Services and Your Rights
UMP and state law have established standards to:
- Help ensure the competence and professional conduct of mental health service providers.
- Support your right to receive treatment only after informed consent.
- Protect the privacy of your medical information.
- Help you understand which services UMP covers, and the limits on your coverage.
For more information about covered mental health services, or if you have a question or concern about your mental health benefits, please contact UMP Customer Service at 1-800-762-6004.
If you think any mental health benefit you have received from UMP may not conform to the terms of your coverage contract or your rights under the law, contact UMP at 206-521-2000. If you have a concern about the qualifications or professional conduct of your mental health provider, call the Washington State Department of Health at 1-800-525-0127 or their customer service department in Health Professions Quality Assurance at 360-236-4902.
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