For Mental Health or Substance Abuse Help

This section of your online member handbook explains:

Does my health plan cover mental health and substance abuse services?
Who do I call for mental health or substance abuse help?
Do I need to call my Primary Care Physician before getting help?
What if I need help after hours?


Q: Does my health plan cover mental health and substance abuse services?
Yes. Check your coverage documents - either a Certificate of Coverage booklet, your Summary Plan Document or your insurance policy - and any riders your employer may have added to your insurance coverage for the specific behavioral health services covered under your plan. Standard documents are available here online, but your employer's plan may differ.

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Q: Who do I call for mental health or substance abuse help?

• All members: You don't need to call your Primary Care Physician first. Our mental health experts can answer questions and point you in the direction of the help you need. They can:
• Find providers who can schedule an appointment with you, immediately if necessary. Authorize you to see a credentialed provider with expertise in the area you need assistance in.
• These services are confidential. Have your ID card ready to verify your coverage and call our Behavioral Health staff.
• PPO members: By calling our Behavioral Health staff, you are assured of working with an in-network provider for coverage at the Network Benefits level. You do not need to contact Priority Health to arrange for mental health services at the Non-Network level.
• POS members: Priority Health's Behavioral Health department will arrange for care at the Preferred  Benefits level. You do not need to contact Priority Health to arrange for mental health services at the Alternate Benefit level.

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Q: Do I need to call my primary care physician before getting help?
No. You do not need to call your PCP before accessing mental health or substance abuse services through our Behavioral Health Services Department.

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Q: What if I need help after hours?
If the situation is life-threatening, call 911 or go to a hospital emergency room.

If it is not life-threatening but it can't wait until regular business hours, call the regular Behavioral Health Services phone number. Our answering service will contact a behavioral health clinician, who will return your call promptly.

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