Mental Health/Substance Abuse Care
Biologically based mental illness (schizophrenia, schizoaffective disorder, biopolar affective disorder, major depressive disorder, specific obsessive compulsive disorder, and panic disorder) are paid as any other Sickness. They are paid at 80% (PPO) and 50% (Non-PPO).
Outpatient and inpatient mental health/substance abuse care (other than biologically bases) is payable as follows:
- Outpatient care is payable at 80% (PPO allowable) or 50% (Non-PPO) of usual
and customary charges up to a maximum of $1,000 per year. There
is a $15 co-pay for each visit. The $1,000 maximum is combined
services received from UNC Counseling Center and outside counseling.
- Inpatient mental health/substance abuse care is payable up to 80% (PPO) allowable or 50% (Usual and customary Non-PPO) payable up to a maximum of 45 days per plan year. Each 1 day of inpatient care will reduce 2 days of the Partial Care Benefit.
Mental Health/Substance Abuse Care
Pregnancy and Newborn Benefits
