How am I covered under the mental and nervous disorders benefit?
In-patient visits for mental and nervous disorders are covered to a maximum amount of visits of 30 per year. If you go to an in-network provider, your are covered at 100%. If you happen to go to an out-of-network provider, then the payment for the visit is reimbursable at 70% of reasonable and customary. Outpatient visits for mental and nervous disorders are covered to a maximum amount of visits of 45 per year .If you go to an in-network provider, your co-pay visit is $25.00. If you happen to go to an out-of-network provider, then the payment for the visit is reimbursable at 70% of reasonable and customary after the $350.00 annual deductible has been met. The services must be rendered by a licensed certified social worker, psychologist, or psychiatrist. In the State of California, a licensed family marriage therapist is a covered provider for psychotherapy only (marriage counseling is not covered).
