No Cost Sharing for Behavioral Health Services. Cost sharing is eliminated for all professional and ancillary services for the treatment, rehabilitation, prevention, and identification of mental illnesses, substance use disorders, and trauma spectrum disorders. This includes cost sharing for inpatient, detoxification, residential treatment, and partial hospitalization, intensive outpatient therapy, outpatient, and prescription drugs that are subject to No Cost Sharing for Behavioral Health Services. Cost sharing means any copayment, coinsurance, deductible, or any other form of financial obligation of an enrollee other than a premium or a share of a premium, or any combination of any of these financial obligations.
No Cost Sharing for Behavioral Health Services. Cost Sharing is eliminated for all professional and ancillary services for the treatment, rehabilitation, prevention and identification of mental illnesses, substance use disorders and trauma spectrum disorders. This includes cost sharing for inpatient, detoxification, residential treatment and partial hospitalization, intensive outpatient therapy, outpatient and prescription drugs that are subject to No Cost Sharing for Behavioral Health Services. Cost Sharing means any copayment, coinsurance, deductible or any other form of financial obligation of an enrollee other than a premium or a share of a premium, or any combination of any of these financial obligations. When in-network access to mental health or substance use disorder services are not reasonably available, Presbyterian will provide access to out-of-network services with no cost-sharing obligations.
No Cost Sharing for Behavioral Health Services. Cost sharing is eliminated for all professional and ancillary services for the treatment, rehabilitation, prevention and identification of mental illnesses, substance use disorders and trauma spectrum disorders. This includes cost sharing for inpatient, detoxification, residential treatment and partial hospitalization, intensive outpatient therapy, outpatient and all medications, including brand-name pharmacy drugs when generics are unavailable. Cost sharing means any copayment, coinsurance, deductible or any other form of financial obligation of an enrollee other than a premium or a share of a premium, or any combination of any of these financial obligations. Some mental health services require Prior Authorization. The In-network Behavioral Health Practitioners/Providers will be responsible for obtaining Prior Authorization, when required. For Out-of-network Services, Members need to contact our Behavioral Health Department to obtain Prior Authorization, when required. Please refer to the Prior Authorization Section for services that require Prior Authorization. Behavioral Health Department directly at (505) 923- 5470 or 0-000-000-0000. For assistance with accessing or for questions related to mental health services, you may do the following: • Schedule an appointment with a behavioral health provider • Call your PCP • Call our Behavioral Health Department directly at (000) 000-0000 or 0-000-000-0000 Partial Hospitalization can be substituted for the Inpatient mental health services when our Behavioral Health Department approves the Prior Authorization request. Partial Hospitalization is a non-residential, Hospital-based day program that includes various daily and weekly therapies. Acute medical detoxification benefits are Covered under Inpatient and Outpatient Medical services found in the Benefits Section and will cover no less than 30 days in an alcohol dependency treatment center and no less than 30 outpatient visits for alcohol dependency treatment. Some services require Prior Authorization except when requesting emergency services.
