ALERT! Admission to a Residential Treatment Center (RTC) must be preauthorized.
The plan covers mental health services for treatment of neuropsychiatric, mental, and personality disorders, including eating disorders. Marriage or family counseling is not covered.
Your provider must notify the plan upon admission when you receive the following services:
- Inpatient admission
- Partial Hospitalization Program (PHP)
Services are considered "inpatient" when you are admitted to a facility. See above for services requiring plan notification.
The plan pays for these services according to the network status of the provider, unless your condition is a medical emergency. All covered professional services are paid based on the allowed amount.
Outpatient mental health services are covered the same as any other medical service. The plan pays based on the allowed amount and the network status of the provider. Preauthorization for outpatient mental health services is not required in most cases; see above for services requiring plan notification.
ALERT! Services must be provided by a covered provider type.