Understanding Your Mental Health Benefits
Who is considered a mental health provider?
In California, there are multiple types of licensed mental health providers. There are differences in training and education, scopes of practice, and focus areas, some of which are highlighted below:
| Clinical Psychologist | A psychologist with a doctoral degree in psychology from an accredited/designated program. Many clinical psychologists provide testing and evaluation for vocational, aptitude, and personality purposes. |
| Psychiatrist | A medical doctor with special training in the diagnosis and treatment of mental health issues. A psychiatrist can prescribe medication. Not all psychiatrists provide individual, ongoing counseling services. |
| Licensed Clinical Social Worker (LCSW) | A counselor with a master's degree in social work from an accredited graduate program who has completed additional postgraduate licensing requirements. LCSWs are often trained to consider intersections between systems, individuals, and their mental health. |
| Licensed Marriage and Family Therapist (LMFT) | A counselor with a master's degree, with special education and training in marriage and family therapy and systems. LMFTs are often trained to understand relationship dynamics and work with individuals as well as couples and families. |
| Licensed Professional Clinical Counselor (LPCC) | A counselor with a master's degree in counseling from an accredited graduate program. LPCCs are often trained in career development theories and techniques, in addition to offering traditional counseling services. |
Does my UC insurance plan cover mental health services?
Yes, each UC insurance plan covers mental health services.
See the UC Net Behavioral Health Benefits for information. UC Care and UC Health Savings Plan members access behavioral/ mental health services via Anthem. UC Blue and Gold and HealthNet members access these services via MHN. Kaiser members can access behavioral/mental health services through Kaiser and/or Optum.
Employee Assistance counselors are familiar with each plan and can answer questions that folks may have after reviewing UC Net.
How do behavioral health services differ from mental health services?
Behavioral health services also encompass substance abuse services. While this page primarily focuses on outpatient mental health services, Employee Assistance counselors can provide additional information about other services covered by UC plans.
Am I required to meet with Employee Assistance to access a referral?
No. Employee Assistance offers referral services which can greatly decrease the barriers to and stress of accessing mental health services. In addition, each of the behavioral health service providers (Anthem, MHN, and Optum) can assist with a provider search. By calling the customer service number below for your plan, you will be offered or can request assistance finding a provider with an available appointment.
This encompasses both psychiatry and therapy providers. Once the representative has confirmed some basic information, they will search for a provider who has an available appointment time. They will then follow up with you and provide you with this information, usually within 5-15 business days. Please note that, regardless of whether Employee Assistance or an insurance representative helps to locate an appointment and/or provider, it is the patient’s responsibility to call and schedule with the provider. Due to confidentiality, this cannot be done by another individual.
|
Plan |
Customer Service Number |
|
Anthem (UC Care, UC Health Savings Plan) |
(844) 792-5141 |
|
MHN (HealthNet plans) |
HMO- 888-935-5966 PPO- 800-797-7016 |
|
MHN (Blue and Gold plan) |
800-663-9355 |
|
Optum (Kaiser plan) |
888-440-8225 |
What is the Optum benefit, and how do I use it?
UC Kaiser members are automatically enrolled in Optum, which is a behavioral health insurance company. Optum is not affiliated with Kaiser. To find a provider who accepts Optum, individuals can:
- Schedule an appointment with Employee Assistance to access referral services
- Call Optum at 888-440-8225 and request a provider search
- Find a provider online at the Optum website (create an account or browse as a guest using the access code 11280)
Once a provider is located and requests insurance information, they can confirm coverage using the employee’s first/last name and date of birth. An Optum member card is not provided, and members should not provide their Kaiser card to an Optum provider.
What are the benefits and drawbacks of using insurance for mental health services?
The primary benefit of working with a provider who is in-network with one’s insurance plan is that it keeps costs low. For the majority of the UC insurance plans, working with an in-network provider means visits cost $20/session.
Individuals sometimes choose not to utilize insurance for behavioral/mental health services because it allows them to select from a wider option of providers. For example, many providers with specializations do not accept insurance. Some providers may offer a “superbill” that can be submitted to the insurance provider for partial reimbursement. It is recommended that individuals interested in this option speak with a customer service representative before submitting a reimbursement request.
Insurance providers can also determine that an individual no longer meets “medical necessity” for services, and will no longer provide reimbursement to the provider. In addition, some individuals choose to forgo using insurance for services for privacy reasons, as providers who accept insurance do submit some information to the insurance company.