Mental Health and Substance Abuse Benefits

Network Blue New England will pay benefits for inpatient mental health care in a psychiatric hospital or substance abuse facility up to 60 days per calendar year. Inpatient alcoholism rehabilitation is covered up to an additional 30 days per calendar year.

Pre-authorization for Mental Health and Substance Abuse Care

You must call the Network Blue New England mental health administrator before any non-emergency hospital admission for mental health or substance abuse. The telephone number is on the front of your Network Blue New England identification card. If you do not call in advance for authorization, no benefits will be paid.

In the event of an emergency hospital admission, Network Blue must be notified as soon as possible within 24 hours of the admission. Often, the hospital will make the phone call, but you or a family member must confirm that the call has been made to ensure plan benefits.

If Network Blue determines that your admission was not an emergency and you do not comply with the plan’s pre-authorization requirements, no benefits will be paid.

For confinement in a specialty hospital for mental health and/or drug abuse treatment facility, benefits are payable for up to 60 days per calendar year. For confinement in a specialty hospital for alcoholism treatment, benefits are payable for up to 30 additional days per calendar year.

Network Blue will pay benefits for outpatient treatment of mental health and substance abuse according to the following schedule:

Outpatient Mental Health and Substance Abuse Benefits
Network Blue New England
Mental health/substance abuse treatment $15 copayment for visits 1 – 20
$20 copayment for visits 21 – 30
$30 copayment for visits 31- 40