Mental Health Benefits. A Member is covered for services for the treatment of the following Mental or Behavioral Conditions through Participating Behavioral Health Providers.
Mental Health Benefits. The charges for the diagnosis and treatment of mental Illness, as that term is defined in Title 22, Guam Code Annotated, Section 28103, subject to the same conditions and restrictions applicable to physical Illness.
Mental Health Benefits. Blue Shield’s Mental Health Service Administrator (MHSA) arranges and administers Mental Health Services for Blue Shield Members within California. See the Out-Of- Area Program, BlueCard Program section for an explanation of how payment is made for out of state services. All Non-Emergency inpatient Mental Health Services, in- cluding Residential Care and Non-Routine Outpatient Mental Health Services are subject to the Benefits Management Pro- gram and must be prior authorized by the MHSA. See the Benefits Management Program section for complete infor- mation.
Mental Health Benefits. Blue Shield’s Mental Health Service Administrator (MHSA) arranges and administers Mental Health Services for Blue Shield Members within California. See the Out-Of- Area Program, BlueCard Program section for an explanation of how payment is made for out of state services. All Non-Emergency inpatient Mental Health Abuse Services, including Residential Care, and Non-Routine Outpatient Mental Health Services are subject to the Benefits Manage- ment Program and must be prior authorized by the MHSA. See the Benefits Management Program section for complete information. Routine Outpatient Mental Health Services Benefits are provided for professional (Physician) office vis- its for the diagnosis and treatment of Mental Health Condi- tions in the individual, family or group setting. Non-Routine Outpatient Mental Health Abuse Services Benefits are provided for Outpatient Facility and professional services for the diagnosis and treatment of Mental Health Conditions. These services may also be provided in the of- fice, home, or other non-institutional setting. Non-Routine Outpatient Mental Health Services include, but may not be limited to, the following:
Mental Health Benefits. Outpatient As necessary 90% of network rates 10% co-pay As necessary 50% of network rates Check with your HMO Alcohol & Chemical Dependency Benefits –Inpatient Covered 100% 4 Halfway House 100% Covered 50% 4 Halfway House 50% Check with your HMO; Inpatient services subject to deductible. Alcohol & Chemical Dependency Benefits -Outpatient $3,500 per calendar year 90% of network rates 10% co-pay 5 $3,500 per calendar year 50% of network rates 5 Check with your HMO 2 Deluxe hearing aids are covered at the same rate as basic hearing aids with the member paying the remainder. Discount hearing aids are offered through the XXX XXX. 0 Xxxxxxxxx days may be utilized for partial day hospitalization (PHP) at 2:1 ratio. One inpatient day equals two PHP days.
Mental Health Benefits. I understand that if I am using my health insurance benefits to pay for mental health treatment, and/or substance abuse treatment, my insurance program may need some information from my clinician(s). The information that insurance companies need for initial sessions of outpatient treatment is limited to diagnosis, and type of treatment. However, if my outpatient treatment is to go beyond those initial sessions, then my insurance company will need additional information. If I am going to receive mental healthcare as an outpatient, I understand that my insurance company may have limits on the number of visits that it will pay for. I need to stay informed of my plan’s mental health benefits. If I am going to receive mental health treatment as an inpatient, my insurer will request information from my clinicians about my hospitalization. This additional information allows my insurer to determine if the treatment is medically necessary and if payment for treatment will be authorized. Please continue on the reverse side. MR 0446 IP-OP (Rev. 03/15) Page 1 of 2 GENERAL AGREEMENT - continued - Durable Medical Equipment: Durable Medical Equipment (DME) is medical equipment to be used outside the MR0446 hospital and at home. Examples of DME include nebulizers, wheelchairs and blood pressure monitors. I understand that it is my responsibility to obtain any DME that my healthcare professional says that I need. I am responsible for any and all costs not covered by insurance.
Mental Health Benefits. Blue Shield of California’s MHSA administers and delivers the Plan’s Mental Health Benefits. All Non-Emergency Men- tal Health Services must be arranged through the MHSA. Also, all Non-Emergency Mental Health Services must be prior authorized by the MHSA. For prior authorization for Mental Health Services, Members should contact the MHSA at 0-000-000-0000. All Mental Health Services must be obtained from MHSA Participating Providers. (See the How to Use Your Health Plan section, the Mental Health Services paragraphs for more information.) Benefits are provided for the following Medically Necessary covered Mental Health Conditions, subject to applicable De- ductible/Copayments and charges in excess of any Benefit maximums. Coverage for these Services is subject to all terms, conditions, limitations and exclusions of the Contract, to any conditions or limitations set forth in the benefit descrip- tion below, and to the Principal Limitations, Exceptions, Ex- clusions and Reductions set forth in this booklet. No benefits are provided for Substance Abuse Conditions, unless substance abuse coverage has been selected as an op- tional Benefit by your Employer, in which case an accompa- nying Supplement provides the Benefit description, limitations and Copayments. Note: Inpatient Services which are Medi- cally Necessary to treat the acute medical complications of detoxification are covered as part of the medical Benefits and are not considered to be treatment of the Substance Abuse Condition itself.
Mental Health Benefits. The diagnosis and Medically Necessary inpatient and outpatient treatment of Serious Mental Illness (Severe Mental Illness) and Serious Emotional Disturbances of a Child are covered under the same terms and conditions as any other medical condition.
Mental Health Benefits. Outpatient As necessary 90% of network rates 10% co-pay As necessary 50% of network rates Check with your HMO Alcohol & Chemical Dependency Benefits –Inpatient Covered 100% 3 Halfway House 100% Covered 50% 4 Halfway House 50% Check with your HMO; Inpatient services subject to deductible. $3,500 per $3,500 per Alcohol & Chemical Dependency calendar year calendar year Check with your Benefits -Outpatient 90% of network rates 50% of network HMO 10% co-pay 4 rates 2 Inpatient days may be utilized for partial day hospitalization (PHP) at 2:1 ratio. One inpatient day equals two PHP days.
Mental Health Benefits. The following services are made available by the Participating Mental Health Provider upon referral by the Member's Primary Care Physician as may be necessary and appropriate for short term evaluation or crisis intervention, mental health services or both.
