Mental Health and Substance Abuse Benefits

Members of the Traditional and Flexible MIT Health Plans may see a clinician in MIT Medical’s Mental Health Service for short-term, problem-focused care and/or mental health consultations. As with other specialty services at MIT Medical, there will be a $10 copayment per visit starting January 1, 2010 (except for visits made under the Personal Assistance Program).

Traditional and Flexible MIT Health Plan members may get outside mental health services from a BCBSMA Managed Care Behavioral Health Network provider or from a non-network provider. No authorizations or referrals are required for medically necessary outpatient mental health care (in-network or out-of-network).

Cost of visits

Your out-of-pocket cost is determined by the network status of the provider you’re seeing.

	For in-network provider visits	For out-of-network provider visits
MIT Health Plan member pays:	$10 copayment for each visit. Provider may not bill member for any difference between provider’s fee and MIT Health Plan payment.	The difference between the provider’s fee and the BCBSMA payment of $60 per visit.

Finding or verifying in-network clinicians

To see if a specific clinician is part of the network, or to find a new in-network clinician:

Along the top of the BCBSMA website, click on “Find a doctor.”
Click on the orange link for “I am a member searching for a provider.”
Click on “Find a Behavioral Health Provider.” When the search form opens in a separate window, you can search for a specific provider by name to see if he or she is affiliated with the BCBSMA Managed Care Behavioral Health Network. Or you may find names of in-network providers by specifying Managed Care Behavioral Health under “Select your plan’s network” and entering a zip code.

We do not want to disrupt existing relationships for those already in treatment, so if you have any questions regarding your provider’s network participation, please contact Claims and Member Services at 617-253-5979 or mservices@med.mit.edu.

Prescriptions

You may fill prescriptions at the MIT Pharmacy or at any participating Express Scripts pharmacy. To fill your prescription at the MIT Pharmacy and take advantage of the lower copayments, you must obtain a referral from the MIT Health Plan. Please contact MIT Medical’s Mental Health Service at 617-253-2916 to request this referral.

Contacting BCBSMA

Your BCBSMA insurance card includes contact information for the Managed Care Behavior Health Network. If you need to contact BCBS and have not received your card, please call 877-566-2583.

Submitting claims

Be sure to notify your provider that you are covered through BCBSMA for mental health services. Participating providers are required to submit claims for all services rendered. Non-participating providers are asked to submit claims on your behalf. If he or she refuses to do so, you can submit a claim for reimbursement using the Subscriber Claim Form on our website. Be sure to get the provider’s information and an itemized record of the services, including date of visit, procedure code, diagnosis and charge. You must submit all claims within one year of the date of service.

Resources

MIT Employee Health Plan

2010 MIT Traditional Health Plan brochure (PDF)
2010 MIT Flexible Health Plan brochure (PDF)
2009 MIT Traditional Health Plan brochure (PDF)
2009 MIT Flexible Health Plan brochure (PDF)

Employee health plans

Mental health benefits