Optum administers mental health benefits for associates in the Basic, HSA, PPO and National HMO medical plans. (If you enroll in a local HMO plan not administered by BlueCross BlueShield, contact your HMO provider for mental health coverage information.)
Mental health services may or may not be covered based diagnosis, type of service, source of referral, treatment setting and type of provider. Some services may be covered at certain settings (such as at a counselor’s office) and not covered in a more intensive setting.
Deductibles and out-of-pocket maximums for mental health are combined with the medical deductibles and out-of-pocket maximums.
It is important that you and your provider consult with Optum to determine if a service you are seeking is covered and, if so, at what level.
Pre-certification is required for inpatient services and non-standard services. If these services are not pre-certified, they will be subject to a penalty. To learn more about inpatient and non-standard services, check out the FAQs. To pre-certify, call Optum at 1-866-519-6166.
You can access in-network providers over the phone or online. The best way is to call Optum at 1-866-519-6166. Trained specialists will guide you through the process of accessing treatment. To find providers listed on Optum’s website, go to liveandworkwell.com. If you need to register, learn how in the FAQs.