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Mental health coverage through health system medical plans

Mental illness affects more than 1 in 5 American adults, and for those in healthcare, that statistic can be even higher. Proactively managing your mental health is critical to taking care of yourself and others. That’s why mental health services – from individual counseling or family therapy to residential treatment or rehabilitation programs – can be covered by both health system medical plans.

Inpatient services for mental/behavioral health are covered at the following coinsurance rates after your family deductible is met:

(Preauthorization is required for inpatient services. Coverage of room and board may be denied.)

Outpatient services for mental/behavioral health are covered at the following coinsurance rates after your family deductible is met:

  • Health system network – 10% coinsurance after deductible
  • In-network – 30% coinsurance after deductible
  • Out-of-network – 40% coinsurance after deductible

(Preauthorization is required for ABA therapy.)

Inpatient services for mental/behavioral health are covered at the following coinsurance rates after your individual deductible is met:

  • Health system network – 10% coinsurance after deductible
  • In-network – 30% coinsurance after deductible
  • Out-of-network – 40% coinsurance after deductible

(Pre-authorization is required for inpatient services. Coverage of room and board may be denied.)

Outpatient services for mental/behavioral health are covered as follows:

  • Health system network – $20 copay for office visits; all other services covered 100%
  • In-network – $30 copay for office visits; 30% coinsurance after deductible for all other services
  • Out-of-network – 40% coinsurance after deductible

(Preauthorization is required for ABA therapy.)

Read about the health system’s medical plans and review the medical plan benefits summary chart for more details. It might also be helpful to learn more about deductibles, copays and coinsurance.

To help connect you with support, we have a comprehensive Mental Health Resource Guide with health system, local and national resources, all compiled in one place. Most of the tools are free, confidential and available to all employees and physicians, regardless of benefits eligibility, as well as employees’ household members, including children.