Benefits: Insurance: Mental Health Coverage
Mental Health, Substance Abuse, EAP
As part of the employee medical plans, the State of Idaho has chosen Business Psychology Associates to administer a managed care plan for mental health and substance abuse services.
Pre-Authorization Requirement
Mental Health, Substance Abuse and EAP Benefits require Pre-Authorization from BPA. BPA works on your behalf to see that these services are medically necessary, are matched closely to your needs, and are provided in the least restrictive environment possible. BPA wants you to receive high quality care which is cost effective and which makes effective use of your benefit resources.
Please call BPA at 1-877-427-2327 for pre-authorization. Pre-authorization is required for both in-network and out-of-network care.
Employees and their dependents enrolled in mental health services must obtain pre-authorization for any services each benefit period. July 1st of each year marks the beginning of a new benefit period and the start of a new deductible period. Any authorizations issued expire June 30th of each year.
Mental Health Parity Plan Design |
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| Benefit | Blue Cross Traditional | Blue Cross PPO in Network | Blue Cross PPO Out of Network |
| EAP | Five Visits per person, per year |
Five Visits per person, per year |
No Benefit |
Mental Health and Substance Abuse Inpatient and Outpatient Services |
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| Deductible (No Separate Deductible) |
$350 Individual/ |
$250 Individual/ |
$500 Individual/ |
| Inpatient Care | Plan pays 80% of allowable |
Plan pays 85% of allowable |
Plan pays 70% of allowable |
| Outpatient Care | Plan pays 80% of allowable |
$20 Copay for Office Visits |
Plan pays 70% of allowable |
| Annual Maximum Benefit |
Up to 8 days of inpatient care per insured, per benefit period; Up to 30 visits of outpatient care per insured per benefit period. (Benefits will be extended with no annual maximum if an insured’s diagnosis falls within the Mental Health Parity guidelines) |
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Out of Network services include services from a provider not contracting with BPA. You will be responsible for payment of your designated percentage of the balance. If you choose a non-contracting provider, you may be responsible for charges exceeding the maximum allowable for that service.
For further information see www.bpahealth.com.