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 Behavioral Health

If you enroll in a State medical plan, you and your enrolled dependents will automatically receive behavioral health coverage. However, your behavioral health benefits vary depending on the medical plan in which you are enrolled.

EPO PLANS

Your EPO plan must authorize all of your behavioral health benefits to be eligible for coverage. In addition, out-of-network services are not covered under any of the EPO plans. Contact your EPO plan for more details.

PPO AND POS PLANS

Your behavioral health benefits are provided by APS Healthcare Bethesda, Inc. The following types of services are covered under this plan:

  • Inpatient facility and professional services;
  • Partial hospitalization;
  • Intensive Outpatient Program; and
  • Outpatient facility and professional services.

For a list of participating providers, contact APS at 1-877-239-1458 or visit APS Healthcare - Enter company code SOM2002 to access the plan's website

Notes about Your Behavioral Health Coverage

  • Inpatient Care - There is no limit to medically necessary preauthorized inpatient days.
  • Outpatient Care - There is no limit on the number of medically necessary/treatable visits per year

 

The deductible noted in our benefits guide under medical applies to the behavioral health and the medical combined for those enrolled in either the PPO or POS plans. It can be satisfied by either plan or through a combination of both out of network medical and out of network behavioral health. We missed adding that note in the Behavioral Health section of the Benefit Guide. You have our sincere apologies for any confusion. We carefully and repeatedly review the benefit guide prior to publication and to learn we missed something is very upsetting.