OptumHealth Mental Health Benefits

Benefits

Mental health benefits by OptumHealth Behavioral Solutions are provided to Self-Funded enrolled participants. Kaiser participants receive Mental Health benefits from Kaiser.

Virtual Behavioral Coaching

Coaching provides personalized, self-paced support to those who need help managing symptoms of depression, stress and anxiety. The eight-week structured program delivers a tailored path to help you build coping skills with the help of a dedicated coach. As a member, you also get 24/7 access to on-demand resources, tools and techniques to help you. See the Virtual Behavioral Coaching flyer for more information.

Self Care from AbleTo

Get access to self-care techniques, coping tools, meditations and more — anytime, anywhere. With Self Care, you’ll get personalized content that’s designed to help you boost your mood and shift your perspectives. Tap into tools created by clinicians that are suggested for you based on your responses to a short optional assessment. Self Care is here to help you feel better — and it’s available at no additional cost to you as part of your Optum Behavioral Health/Employee Assistance Program. See the Self Care flyer for more information.

Chemical Dependency

Chemical Dependency benefits are provided by OptumHealth Behavioral Solutions to all participants and their eligible dependents regardless of their medical plan. Pre-authorization is required for all Chemical Dependency benefits. Contact OptumHealth Behavioral Solutions 24 hours a day, 7 days a week toll-free at 1-877-225-2267.

Schedule of Benefits for Chemical Dependency:

All levels of care includes detox
$25,000 Annual Maximum
$0 copay and covered at 100%
$35,000 Lifetime Maximum

Serious Mental Illness

Pre-Authorization is required for all Inpatient and Outpatient and Serious Mental Illness benefits. Serious mental illness diagnosis include: Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, Major Depressive Disorder, Panic Disorder, Obsessive-Compulsive Disorder, Pervasive Developmental Disorders (Autism), Anorexia, Bulimia Nervosa, Severe Emotional Disturbances of Children (SED). See the Schedule of Benefits below.

Schedule of Benefits for Serious Mental Illness

Inpatient Deductible	None
Inpatient Per Admission Fee	Same as Medical Plan
Impatient, Partial and Day Treatment	30 Days per calendar year* covered at 100% after any applicable admission fee
*Days to be determined based on the following ratios:
Inpatient Treatment –	1 Day
Residential Treatment –	70% of 1 Day
Day Treatment –	60% of 1 Day
Outpatient Mental Health	30 Visits $5 co-payment per visit

Serious Mental Illness Benefits

Inpatient Deductible	None
Inpatient Per Admission Fee	Same as Medical Plan
Impatient, Partial and Day Treatment	Unlimited days covered at 100% after any applicable admission fee
Annual Maximum Benefit for Inpatients Treatment	None
Outpatient Mental Health Treatment	Unlimited Visits $5 co-payment per visit
Lifetime Dollar Maximum for Parity Diagnosis: Applied to Medical Plan lifetime dollar maximum benefit.