Benefits are included in your medical plan premium. If you are seeking care through the UC Blue & Gold HMO or through Optum as a Kaiser HMO member, there is no charge for your first three routine office or telemental health visits; you will be charged a $20 copayment for each of your following visits.
You do not need a referral from your primary care provider to see a behavioral health provider, but some services require preauthorization from your behavioral health plan.
Behavioral health and substance abuse coverage are provided by Kaiser and Optum. Kaiser members may access care from Kaiser behavioral health providers and from Optum in-network providers.
Please note: Kaiser and Optum do not coordinate care or costs of behavioral health services and each plan has specific requirements. Therefore, it is important to select behavioral health services carefully and follow all of the plan guidelines and authorization requirements for the behavioral health services plan you select.
For information about your benefits, preauthorization for certain services, and help finding a provider:
- Optum — Call 888-440-8225
- Kaiser (Southern California) — Call your local clinic or 800-900-3277 after hours
- Kaiser (Northern California) — Call your local clinic or 800-464-4000 after hours
Behavioral health and substance abuse coverage are provided by Health Net Behavioral Health (formerly known as MHN). Members may access care from Health Net Behavioral Health in-network providers.
For information about your benefits, preauthorization for certain services, and help finding a provider, call Health Net Behavioral Health at 800-663-9355.
Behavioral health and substance abuse coverage are provided by Anthem Blue Cross.
Benefits are included in your medical plan premium. Charges for routine office or telemental health visits vary by plan and provider type, and some services require preauthorization. For information about your benefits and help finding an in-network provider, call Anthem at 844-437-0486.
CORE members have access to Anthem in-network providers. There is a 20% coinsurance for covered services after meeting the deductible.
UC Care members have access to Anthem in-network providers and to out-of-network providers. If you see an in-network provider, there is no charge for your first three visits, then a $20 copayment. If you choose to see an out-of-network provider, you'll pay 50% coinsurance and you may need to pay your provider directly for services and submit a claim for reimbursement.
UC HSP members have access to Anthem in-network providers and to out-of-network providers.
After meeting the deductible, there is a 20% coinsurance for covered services from in-network providers and a 40% coinsurance for covered services from out-of-network providers. If you choose to see an out-of-network provider, you may need to pay your provider directly for services and submit a claim for reimbursement.
Behavioral health and substance abuse coverage are provided by Kaiser.
Behavioral health benefits are provided by Medicare and by Anthem Blue Cross. Members are covered for outpatient services not covered by Medicare from all in- and out-of-network licensed behavioral health providers, including psychiatrists, psychologists, MFTs and MFCCs. Please check with your provider to be sure they are available under this plan.
The plan provides coverage for mental health services provided by a state-licensed psychiatrist or doctor, clinical psychologist, clinical social worker, clinical nurse specialist, nurse practitioner, physician assistant, state-licensed Marriage and Family Therapists (MFTs) and Marriage, Family, and Child Counselors (MFCCs) and other Medicare-qualified mental health care professional as allowed under applicable state laws. Both individual and group therapy sessions are covered for a $20 copayment per session.
The UC Medicare Choice plan also provides coverage for services obtained from licensed behavioral health providers who do not participate with Original Medicare. If you receive covered services from non-Medicare participating providers, you will pay upfront for the services received, and then submit a reimbursement request to UnitedHealthcare®. UnitedHealthcare will reimburse the total amount you paid minus the $20 copayment. UnitedHealthcare network or Medicare-participating providers will submit claims directly to UnitedHealthcare and you will pay your copayment to the provider directly.
Inpatient services are also covered.
Regardless of whether you're enrolled in UC benefits, the
faculty and staff assistance program (sometimes called an Employee Assistance Program) offered by your campus, medical center or lab offers free, confidential resources for emotional health — often available right on campus.
