The following information applies to services on or after January 1, 2010.

Chemical dependency is defined as an illness characterized by a physiological or psychological dependence on a controlled substance or alcohol. Chemical dependency does not include dependence on tobacco, caffeine, or food.

The following services must be preauthorized by the plan:

• Inpatient stays
• Intensive outpatient treatment
• Partial hospitalization
• Residential treatment settings

Inpatient

ALERT! All inpatient services for chemical dependency treatment must be preauthorized by the plan. Inpatient services that are not preauthorized may not be covered.

Services are considered “inpatient” when your stay at a facility is expected to be longer than 24 hours. You pay a $200 per day copay for inpatient facility services, up to $600 per calendar year. This copay covers charges by the facility. However, services by professional providers (for example, doctors) may be billed separately from the facility. The plan pays for these services according to the network status of the provider, unless your condition is a medical emergency.

Outpatient

Outpatient chemical dependency services are covered as any other medical service. The plan pays based on the network status (network or non-network) of the provider. See this list for chemical dependency services that must be preauthorized by the plan.