Mental Health and Substance Abuse. 4.6.11.1 The Contractor shall have written Mental Health and Substance Abuse Policies and Procedures that explain how they will arrange or provide for covered mental health and substance abuse services. Such policies and procedures shall include Advance Directives. The Contractor shall assure timely delivery of mental health and substance abuse services and coordination with other acute care services.
Mental Health and Substance Abuse. Magellan manages behavioral health services for participants of the Provider Choice and PPO plans. For pre-authorization, please call Magellan at (000) 000-0000.
Mental Health and Substance Abuse. ADMINISTRATION Technical Requirement For Behavior Treatment Plan Review Committees Revision FY’12 Application: Prepaid Inpatient Health Plans (PIHPs) Community Mental Health Services Programs (CMHSPs) Public mental health service providers Exception: State operated or licensed psychiatric hospitals or units when the individual’s challenging behavior is due to an active substantiated Axis I diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition or successor edition published by the American Psychiatric Association.
Mental Health and Substance Abuse by adding the following provision:
Mental Health and Substance Abuse. (a) Follow-Up Hospitalization After Mental Illness (7 day)
Mental Health and Substance Abuse. Magellan manages behavioral health services for participants of the Provider Choice and PPO plans. For pre-authorization, please call Xxxxxxxx at (000) 000-0000. Eye Xxxxxxxxx provides an eye care plan through VSP (Vision Service Plan). Coverage is available for routine vision exams, glasses and/or contact lenses and laser vision correction discounts.
Mental Health and Substance Abuse. Mental health and substance abuse treatment will be provided through a managed care program which will include a full range of service providers, including psychiatrists and certified alcohol and drug counselors. Providers must be available within a reasonable distance in all parts of the State, provided, however, that the program will pay the costs of treatment of a provider not included in the network for those persons for whom an appropriate provider is not available in his/her home county. The program will provide timely responses to emergency calls. The service providers will be paid on a discounted fee for service basis. The financial structure will include incentives for the program to provide sufficient inpatient treatment. Effective with the benefit year beginning July 1, 1995, all mental health/substance abuse benefits will be provided pursuant to Section 35.05 below.
Mental Health and Substance Abuse. GHP manages behavioral health services for participants of Provider Choice and PPO. For pre- authorization, please call GHP at (000) 000-0000.
Mental Health and Substance Abuse. In accordance with Federal Mental Health Parity requirements, the plan will not apply any financial requirement or treatment limitation to Mental Illness, Alcoholism or Drug Abuse benefits in any classification that is more restrictive than the predominant financial requirement or treatment limitation applied to substantially all medical/surgical benefits in the same classification.
Mental Health and Substance Abuse. Outpatient services - Visit/consultation $20 copayment per visit • Inpatient services - Semi-private room & board - Physician visit $250 copayment per admission Covered in full Prescription Drugs Covered medications, diabetic supplies and contraceptive devices purchased at a network pharmacy • Copayment applies to each fill, up to a 30-day supply for retail • Includes maintenance drugs at a retail or mail order pharmacy • Only certain drugs are considered “maintenance” and are available for a supply greater than 30 days. • Important notes: - If you choose to buy a brand drug, you pay the brand copay Refer to your prescription drug program flyer for details. Retail (30 day supply): $10 copay /tier 1 $30 copay / tier 2 $50 copay / tier 3 90 day supply at retail for 3 copayments Mail Order (90 day supply): $20 copay /tier 1 $60 copay / tier 2 $100 copay / tier 3 Maximum for Services Subject to $250 Copayment Individual Maximum Family Maximum $250 per member per plan year $500 per family per plan year Other Fitness Club Reimbursement Vision Hardware (per member every two plan years) $200 maximum reimbursement (limited to one member per enrolled household per plan year) $100 maximum reimbursement for frames and lenses.
