How to Understand Behavioral Health Insurance Benefits
- 1). Read the written benefits overview created by your employer if you participate in an employer-sponsored health plan. The overview, at a minimum, will have information about pre-authorization requirements and benefit limitations. The overview is often found in materials distributed by your human resources department or on your company's intranet.
- 2). Review your health insurance plan's summary program description. The SPD is a document the health plan makes available to their members and lists very specific benefit information including what is covered and what is not. You can get a copy of the SPD from your health plan or your human resources department.
- 3). Call the health plan or health management company that manages your behavioral health care benefits. The number is found on the back of your Member ID card. The representatives can look up your specific coverage in their computer systems and quote you information about your benefits. They can answer questions to help you understand your behavioral health benefits.
- 4). Visit the website of your health plan or the health management company that manages your behavioral health benefits. Create a login to access the member services portal of their website. On that portal, you will find information on your behavioral health benefits that are explained in a clear manner you can understand.
- 5). Call and ask your health insurance broker to explain your behavioral health coverage. This option is for individuals who have used a broker to obtain coverage. Your broker is versed in understanding benefits plans and can provide the specifics to you or find the answers you need if he does not know them.
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