Services

Summary of Behavioral Health Service Benefits

Below is a list of your covered behavioral health benefits. These services are covered only when a mental health provider says they are necessary to treat a covered mental health or substance use condition. For some services, your provider must get approval from us before you get the service. Your provider will take care of getting any needed approvals.

Type of Services Benefit Limit Is prior approval necessary?
EMERGENCY BEHAVIORAL HEALTH SERVICES

Crisis Evaluation

  • Community Mental Health Center Emergency or Crisis Walk-In Clinics
  • Hospital Emergency Room
  • 911 Emergency Response
No limit if provider says the service is needed to treat your mental illness. NO
 Inpatient Treatment

  • At hospitals serving BHI members (See provider directory)
No annual limit if:

  • Necessary to treat your mental illness
  • Approved in advance by BHI

Not available for substance use

YES
 Sub-Acute Treatment

  • Sub-acute care in a facility
  • Sub-Acute Low Intensity
  • Emergency Respite (See provider directory)
No annual limit if:

  • Necessary to treat your mental illness
  • Approved in advance by BHI

Not available for substance use

YES
BEHAVIORAL HEALTH TREATMENT SERVICES
 Behavioral Health Screening

  • Evaluation/Assessment
  • Limited to sessions needed for evaluation
NO
  • Psychological or neuropsychological Testing
  • Covered if necessary to treat your mental illness
  • Must be approved in advance by BHI
YES
 Outpatient Treatment

 Case Management

 Medication Management

 Clinical Behavioral Health Counseling/Therapy

  • Individual
  • Group
  • Family
  • No annual limit based on if the service is necessary to treat your mental illness

 

NO
REHABILITATION & RECOVERY SERVICES
 Residential Services

 Day Treatment

 Intensive In-Home Services

 Intensive Outpatient Services

  • Partial Hospitalization (PHP)
  • Mental Health Intensive Outpatient Services

 Respite Services

No annual limit if:

  • Necessary to treat your mental illness
  • Approved in advance by BHI
YES
 Psychosocial Rehabilitation

 School-Based Services

 Deaf and Hard of Hearing Services

 Vocational Services

 Senior Services

 Peer Specialist Services

 Drop-In Center Services

No annual limit if necessary to treat your mental illness NO
COVERED SUBSTANCE USE SERVICES
 Substance Use Screening

  • Alcohol or Drug evaluation/assessment
  • Evaluation of Patient Self-Assessment
  • Screening to determine appropriate treatment
  • Drug Screening & Monitoring
  • Social ambulatory detoxification services

 Individual Outpatient Substance Use Disorder

 Counseling/Therapy

 Methadone Medication 

Assisted Treatment

No annual limit if the service is necessary to treat your substance use disorder NO
 Intensive Outpatient

 Group Outpatient for Substance Use Disorder

 Counseling/Therapy

No annual limit if:

  • Necessary to treat your substance use disorder
  • Approved in advance by BHI
YES
SUBSTANCE USE SERVICES NOT COVERED
  Inpatient Treatment

 Sub-Acute Treatment

 Residential Treatment

  DUI Education

Additional Behavioral Health Services

Peer Outreach
The Peer Outreach Program is a free service available to BHI members. The program helps you navigate your recovery through the support of peer specialists, who have their own lived experience with mental illness and recovery.

Care Manager
BHI Care Managers can assist you with getting appropriate and timely access to care for their behavioral health, substance use, and physical health care needs. We assist you by coordinating care across multiple systems, ensuring you have access to healthcare providers, and ensure that plans of care are communicated between systems to promote cost-effective, non-duplicative services.

Drop-In Centers
BHI’s Drop-In Centers create a safe, sober, supportive, and friendly environment for you to maintain your recovery while staying connected with others.  Members have access to wellness classes, support groups, healthy meals, events and outings, as well as a resource center, library, computer lab, and food bank.  Resource Associates and Peer Specialists are available to meet with members individually to help locate needed resources or support you in your recovery goals.

Integrated Care
Integrated Care means making sure you are receiving the whole-person care you deserve. By whole-person care, we mean having your physical health and behavioral health needs (behavioral health may include mental health or substance abuse or both) addressed from a team approach. Our goal is to make sure your Providers (doctors, therapists and counselors) are communicating with each other to provide you with the right high-quality care.