How Mental Health and Substance Abuse Benefits Work

The mental health and substance abuse benefits are network-based and give participants a choice when it comes to receiving mental health and substance abuse treatment:

• For outpatient care, when the participant uses a network provider, he or she must pay a copayment. Then the plan pays 100%. If a participant uses an out-of-network provider, he or she must pay coinsurance.
• For inpatient care, the participant pays a coinsurance.

Participants must call CBH at 800-852-7440 to receive information and a referral to an appropriate CBH network provider for inpatient and intermediate levels of care. For network outpatient care, participants can self-refer to a CBH network provider. Pre-authorization is not required if employee is using "in-network" providers. Participants can call CBH for assistance in finding an appropriate network outpatient provider or can search for a provider on the CBH web site (www.cignabehavioral.com). If a participant does not call before treatment begins or elects to use an out-of-network provider, the participant will be responsible for additional out-of-pocket costs.