F. MENTAL HEALTH (APPLICABLE TO INDEMNITY PLAN AND PACIFICARE MEMBERS AND DEPENDENTS)
Mental Health and Counseling benefits are provided through PacifiCare Behavioral Health as follows:
1. Mental Health/Counseling.
- Inpatient: 30 days per calendar year
- Outpatient: 30 visits with $0 co-payment
2. Serious Mental Illnesses
- Inpatient: Unlimited days covered at 100%
- Outpatient: Unlimited visits with $0 co-payment
A serious mental illness is one of the following:
- Schizophrenia
- Schizoaffective disorder
- Bipolar disorder (manic-depressive illness)
- Major depressive disorder
- Panic disorder
- Obsessive-compulsive disorder
- Pervasive developmental disorder or autism
- Anorexia (nervosaix)
- Bulimia nervosa
Kaiser enrollees will have the MAP combined with Chemical Dependency Treatment benefits described above, but will receive Mental Health services through Kaiser.
Note: All mental health and chemical dependency treatment services provided through this program must be pre-authorized by PacifiCare Behavioral Health by calling 1-877-225-2267. Eligible Participants are required to utilize network facilities and providers for mental health and substance abuse treatment.
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