Coverage for behavioral and mental health conditions

Overview

Diagnosing behavioral and mental health conditions early makes them easier to treat. Start by finding a doctor in your health plan network who is qualified to treat these conditions.^*

What is a mental health condition?

A mental health condition changes how a person thinks, feels and acts. Some common mental health conditions include

Depression – Continual sadness that lasts at least two weeks or longer
Anxiety – Excessive worry or fear about everyday life
Bipolar disorders – Extreme mood swings that are manic and depressive

What is a behavioral health condition?

Behavioral health is a term that spans the full spectrum of mental and emotional well-being, including how people cope with day-to-day challenges. The term also includes the treatment of mental illnesses, such as depression or anxiety, as well as substance use disorder and other addictive behaviors.

Some common behavioral conditions include:

Substance abuse – Dependence on harmful substances, like alcohol or drugs
Eating disorders – An obsession with food and body image
Addictions – Using a substance or engaging in an activity that interferes with work or responsibilities, despite adverse consequences

What are treatments for mental and behavioral health conditions?

A common form of treatment is counseling with a psychiatrist or psychologist. This may include an overnight stay in a hospital (inpatient) or a visit to a doctor’s office (outpatient). Your doctor may also request psychological tests or prescribe medications.

Coverage

Health plan coverage for behavioral or mental health conditions

Blue Cross and Blue Plus health plans typically cover behavioral and mental health services. The services covered for inpatient or outpatient care, the copays or coinsurance amounts, and the network of providers may be different for each plan.

Many plans also cover medications to treat mental health. To find out if your plan covers your prescription, check your prescription benefits and plan formulary (the list of covered drugs). Some tests and medications might require authorization before your plan will cover them.

Some Blue Cross plans include online treatment programs

Some Blue Cross or Blue Plus plans offer online programs to help treat behavioral or mental health symptoms. These plans often cost less than an office visit.

Learn to Live is an online Cognitive Behavioral Therapy (CBT) program that some Blue Cross and Blue Shield of Minnesota plans offer. This program starts with an online assessment to identify the problem, such as anxiety or depression. Patients then complete courses that teach them how to better manage their specific condition.
Doctor On Demand is an online service. Visit with a licensed psychologist or board-certified psychiatrist using the video feature on your phone, tablet or computer. Mental health professionals are also available by appointment to help with depression, social anxiety, addictions, relationship issues, trauma and loss or workplace stress.

To find out if your plan covers these online programs, call the number on the back of your ID card.

This is general information about how plan benefits work. Review the Summary of Benefits and Coverage (SBC) and your specific health plan benefits book for information about how your plan works.

* It’s up to you to always check if your provider is in your health plan network before you receive services. Not all providers are in every network. You may pay more or for all of your healthcare costs if your provider is out of your network or does not have a contract with Blue Cross (this is called a non-participating provider). You can verify if your provider is in your network by calling customer service at the number on the back of your member ID card.

*Not all plans offer Learn to Live or Doctor On Demand. Some members may not have access to this program. Contact customer service with the phone number on the back of your Blue Cross ID card to verify your coverage.