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Mental health
Q: What types of Mental Health benefits will be provided?
A: Under the BC+ Standard Plan, full coverage with a $1 co-payment per visit is
covered. Coverage under the BC+ Benchmark Plan is based upon coverage in the WI
State Employees’ Health Plan, and includes outpatient mental health and
substance abuse treatment, day treatment, and inpatient hospital stays. For more
information, see http://www.emhandbooks.wi.gov/bcplus/
and refer to 38.2 Standard and Benchmark Plans.
Q. For the Benchmark Plan, are there any copays for outpatient mental
health and substance abuse treatment, including visits and day treatment?
A. Under the Benchmark Plan, copayments for mental health and substance abuse
services are applied on a per visit basis. A visit is defined as all services
delivered on the same date of service by the same performing provider. A single
copayment applies regardless of the number or type of procedures and services
administered during the visit. There are no limits on copayments for mental
health and substance abuse services. Mental health and substance abuse
copayments are as follows:
- All day treatment services - $10 per day
- Inpatient hospital - $50 per hospital stay (for mental health and
substance abuse)
- Narcotic treatment services - $15 per visit. Lab tests do not require a
copayment.
- Outpatient mental health services - $15 per visit. Electroconvulsive
therapy and pharmacological management do not require a copayment.
- Outpatient substance abuse services - $15 per visit.
Q. Are the Benchmark Plan limits on substance abuse services applicable to
medical detox?
A. Yes, the Benchmark Plan limits apply to medical detox. The copayment is
$50 per hospital stay.
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