Tag: behavioral health

In Hard-Hit Areas, COVID’s Ripple Effects Strain Mental Health Care Systems

Although mental health services continued largely uninterrupted in areas with low levels of the coronavirus, behavioral health care workers in areas hit hard by COVID-19 were overburdened.

In late March, Marcell’s girlfriend took him to the emergency room at Henry Ford Wyandotte Hospital, about 11 miles south of Detroit.

“I had [acute] paranoia and depression off the roof,” said Marcell, 46, who asked to be identified only by his first name because he wanted to maintain confidentiality about some aspects of his illness.

Marcell’s depression was so profound, he said, he didn’t want to move and was considering suicide.

“Things were getting overwhelming and really rough. I wanted to end it,” he said.

Marcell, diagnosed with schizoaffective disorder seven years ago, had been this route before but never during a pandemic. The Detroit area was a coronavirus hot spot, slamming hospitals, attracting concerns from federal public health officials and recording more than 1,000 deaths in Wayne County as of May 28. Michigan ranks fourth among states for deaths from COVID-19.

The crisis enveloping the hospitals had a ripple effect on mental health programs and facilities. The emergency room was trying to get non-COVID patients out as soon as possible because the risk of infection in the hospital was high, said Jaime White, director of clinical development and crisis services for Hegira Health, a nonprofit group offering mental health and substance abuse treatment programs. But the options were limited.

Still, the number of people waiting for beds at Detroit’s crisis centers swelled. Twenty-three people in crisis had to instead be cared for in a hospital.

This situation was hardly unique. Although mental health services continued largely uninterrupted in areas with low levels of the coronavirus, behavioral health care workers in areas hit hard by COVID-19 were overburdened. Mobile crisis teams, residential programs and call centers, especially in pandemic hot spots, had to reduce or close services. Some programs were plagued by shortages of staff and protective supplies for workers.

At the same time, people battling mental health disorders became more stressed and anxious.

“For people with preexisting mental health conditions, their routines and ability to access support is super important. Whenever additional barriers are placed on them, it could be challenging and can contribute to an increase in symptoms,” said White.

After eight hours in the emergency room, Marcell was transferred to COPE, a community outreach program for psychiatric emergencies for Wayne County Medicaid patients.

“We try to get patients like him into the lowest care possible with the least restrictive environment,” White said. “The quicker we could get him out, the better.”

Marcell was stabilized at COPE over the next three days, but his behavioral health care team couldn’t get him a bed in one of two local residential crisis centers operated by Hegira. Social distancing orders had reduced the beds from 20 to 14, so Marcell was discharged home with a series of scheduled services and assigned a service provider to check on him.

However, Marcell’s symptoms ― suicidal thoughts, depression, anxiety, auditory hallucinations, poor impulse control and judgment ― persisted. He was not able to meet face-to-face with his scheduled psychiatrist due to the pandemic and lack of telehealth access. So, he returned to COPE three days later. This time, the staff was able to find him a bed immediately at a Hegira residential treatment program, Boulevard Crisis Residential in Detroit.

Residents typically stay for six to eight days. Once they are stabilized, they are referred elsewhere for more treatment, if needed.

Marcell ended up staying for more than 30 days. “He got caught in the pandemic here along with a few other people,” said Sherron Powers, program manager. “It was a huge problem. There was nowhere for him to go.”

Marcell couldn’t live with his girlfriend anymore. Homeless shelters were closed and substance abuse programs had no available beds.

“The big problem here is that all crisis services are connected to each other. If any part of that system is disrupted you can’t divert a patient properly,” said Travis Atkinson, a behavioral consultant with TBD Solutions, which collaborated on a survey of providers with the American Association of Suicidology, the Crisis Residential Association and the National Association of Crisis Organization Directors.

White said the crisis took a big toll on her operations. She stopped her mobile crisis team on March 14 because, she said, “we wanted to make sure that we were keeping our staff safe and our community safe.”

Her staff assessed hospital patients, including Marcell, by telephone with the help of a social worker from the emergency room.

People like Marcell have struggled during the coronavirus crisis and continue to face hurdles because emergency preparedness measures didn’t provide enough training, funds or thought about the acute mental health issues that could develop during a pandemic and its aftermath, said experts.

“The system isn’t set up to accommodate that kind of demand,” said Dr. Brian Hepburn, a psychiatrist and executive director of the National Association of State Mental Health Program Directors.

“In Detroit and other hard-hit states, if you didn’t have enough protective equipment you can’t expect people to take a risk. People going to work can’t be thinking ‘I’m going to die,’” said Hepburn.

For Marcell, “it was bad timing to have a mental health crisis,” said White, the director at Hegira.

At one time Marcell, an African American man with a huge grin and a carefully trimmed goatee and mustache, had a family and a “pretty good job,” Marcell said. Then “it got rough.” He made some bad decisions and choices. He lost his job and got divorced. Then he began self-medicating with cocaine, marijuana and alcohol.

By the time he reached the residential center in Detroit on April 1, he was at a low point. “Schizoaffective disorder comes out more when you’re kicked out of the house and it increases depression,” said Powers, the program manager who along with White was authorized by Marcell to talk about his care. Marcell didn’t always take his medications and his use of illicit drugs magnified his hallucinations, she said.

While in the crisis center voluntarily, Marcell restarted his prescription medications and went to group and individual therapy. “It is a really good program,” he said while at the center in early May. “It’s been one of the best 30 days.”

Hepburn said the best mental health programs are flexible, which allows them more opportunities to respond to problems such as the pandemic. Not all programs would have been able to authorize such a long stay in residential care.

Marcell was finally discharged on May 8 to a substance abuse addiction program. “I felt good about having him do better and better. He had improved self-esteem to get the help he needed to get back to his regular life,” Powers said.

But Marcell left the addiction program after only four days.

“The [recovery] process is so individualized and, oftentimes, we only see them at one point in their journey. But, recovering from mental health and substance use disorders is possible. It can just be a winding and difficult path for some,” said White.

Seeking Help

If you or someone you know is in immediate danger, call 911. Below are other resources for those needing help:

— National Helpline: 1-800-662-HELP (4357) or https://findtreatment.samhsa.gov.

— National Suicide Prevention Lifeline: 1-800-273-TALK (8255).

— Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746.

View the original article at thefix.com

15 June 2020
Anthem Blue Cross Coverage for Drug Rehab and Behavioral Health
Anthem Blue Cross alcohol rehab centers, drug addiction rehab facilities, and behavioral health treatment centers are important providers of mental health care coverage.

Substance use disorders, alcohol abuse, drug addiction, and behavioral health issues are all important mental health conditions that can cause significant dysfunction in your life. They often occur together too, which can make symptoms worse. There is hope, though, as these are all conditions that are treatable and manageable. Anthem Blue Cross alcohol rehab centers, drug addiction rehab facilities, and behavioral health treatment centers are important providers of mental health care.

Table of Contents
Defining Substance Abuse, Alcohol Addiction, and Behavioral Health

Substance abuse is any misuse of a drug or alcohol. If you misuse drugs, you are not necessarily addicted, but you are at significant risk for it. Alcohol or drug addiction refers to a serious illness characterized by being unable to control your use of the substance. Some of the Anthem Blue Cross substance abuse criteria include:
- Intense cravings 
- Regularly using more than you intended 
- Being unable to stop using or to use less 
- Spending a lot of time on using 
- Spending less time on other activities because of substance use 
- Failing to meet your responsibilities because of substance use 
- Using a substance in spite of problems it causes with friends and family 
- Continuing to use a substance even though it causes or worsens health problems 
- Using in dangerous situations, like while driving 
- Needing more and more to get high 
- Having withdrawal when you try to stop using 
Substance abuse, addiction, and alcoholism are all considered to fall under the category of behavioral health. These are conditions related to how you react to the world and how you behave and the choices you make, such as alcohol use or drug use. You may need Anthem Blue Cross Substance abuse care if you find you can no longer control your use of alcohol or drugs.

But behavioral health also includes mental illnesses, like depression, anxiety disorders, and personality disorders. These are conditions that have no known causes but plenty of risk factors, like genetics and substance abuse. Anthem Blue Cross mental health coverage is important because it will cover these mental illnesses that require treatment.

Does Anthem Blue Cross Cover Substance Abuse Treatment and Alcohol Addiction?

Most insurance companies do cover treatment for addiction and substance use disorders, although the degree of coverage depends on each individual plan. Anthem Blue Cross providers may offer detox services, medical treatment for certain types of drug addiction, treatment in rehab facilities, and outpatient therapy. Anthem Blue Cross Blue Shield subsidiaries offer coverage in a number of locations.

It is important that you understand your own Anthem Blue Cross substance abuse policy so that you know what to expect. There may be certain criteria you must meet, for instance, in order to be covered. You may also be facing some co-pays or a deductible, so know what these are before you enroll in treatment.

Does Anthem Blue Cross Cover Mental Health Treatment?

Yes, as with substance use disorders, most insurers do also cover treatment for all types of behavioral health, including mental illnesses. With Anthem Blue Cross mental health providers, you will have access to a great network of professionals. This includes therapists, counselors, physicians, psychologists, and psychiatrists. You also have access to Anthem Blue Cross approved mental health facilities for residential treatment if necessary.

Understanding Anthem Blue Cross Substance Abuse Coverage

What your coverage includes for alcohol addiction or substance abuse depends on the plan you have. Make sure you read over the materials you have for your policy so that you can make better decisions about treatment. Consider factors like deductibles, whether you have to stick with in-network providers, if treatment in an inpatient center will be covered, the costs and coverage for prescription drugs, and more.

Understanding Anthem Blue Cross Mental Health Coverage

With mental health care, you will also need to understand your specific plan or policy before making treatment decisions. You may be required to get treatment from in-network providers or to pay a certain amount in deductible before insurance payments kick in. Read your Anthem Blue Cross mental health policy carefully before deciding on care, and call if you still have questions about coverage.

Anthem Blue Cross In-Network Providers or Out-of-Network Providers?

You may have a choice to make in your treatment services between in- and out-of-network providers. Your policy may require that you choose doctors, therapists, and facilities that are in a group of network providers. This is known as an EPO, exclusive provider organization.

Or, your policy may allow you to choose from any provider. This is a PPO, a preferred provider organization. Choosing an out-of-network facility or physician may cost you more money, so be sure you know what your policy says.

Types of Substance and Alcohol Abuse Treatment Covered by Anthem Blue Cross

When seeking treatment for a substance use disorder or alcohol use disorder, you may have a lot of choices, including between Anthem Blue Cross psychiatrists, therapists, and treatment centers. The first big decision to make is between outpatient and inpatient treatment.

Inpatient care is intensive, residential treatment. You will live in a facility for a few weeks or months to get treatment on a daily basis. This type of care provides around-the-clock supervision, a safe environment, other residents to work with, and a larger team of caregivers to provide different types of therapy and support services.

Some benefits of outpatient care include being able to stay at home, being with family more, and being able to keep going to work. On the other hand, you don’t get as much time to focus on your wellness with just a few sessions of therapy per week.

The choice you make will depend on your particular needs, your Anthem Blue Cross substance abuse policy, and your preferences. Many people find they need the intensive care of a rehab facility, while others find success in outpatient therapy.

Types of Mental Health Care Covered

Treatment for mental illnesses can also be inpatient or outpatient, but it is more often provided on an outpatient basis. If your policy does not cover residential care for mental illness, you can still get effective treatment from Anthem Blue Cross therapists and other providers.

Anthem Blue Cross depression providers, for instance, offer one-on-one therapy sessions on an outpatient basis that can help patients manage their symptoms. This kind of treatment can be very effective as long as you stick with it, get good medical care, and practice healthy lifestyle habits recommended by your therapist.

Coverage for Aftercare Services

Aftercare is an important part of treatment for substance and alcohol abuse in particular. If you spend time in a residential facility, the transition back to home and work can be difficult. Your Anthem Blue Cross substance abuse care policy may include coverage for ongoing therapy on an outpatient basis. This, along with attendance at support group meetings can help you make a smoother transition and reduce the risk of relapse.

Types of Services Anthem Blue Cross May Not Cover

You may have the best policy, but there still are some mental health and addiction services that you’ll find are not covered by your insurance. For example, your Anthem Blue Cross approved alcohol abuse facilities list is not likely to include any luxury centers.

And don’t expect coverage for a private room or some extra services a facility may offer. Things like music therapy, massage, yoga and other exercise classes, or cooking instruction are useful services. However, they may not be covered by your policy.

Choosing the Best Mental and Behavioral Health Services

Your choices may be restricted to some degree by your Anthem Blue Cross substance abuse professionals list or mental health care providers. However, you will still have options, and you shouldn’t have to settle for treatment that doesn’t work for you. Narrow down your list by coverage options, location, and extra costs.

Once you have a list of facilities or treatment providers that match your needs, visit those facilities and speak with staff. Ask any questions you have about the treatment program, and speak with residents if possible in a rehab facility. Make a choice based on practical considerations, like what your policy will cover, but also what works for your personal needs and preferences.

Using Anthem Blue Cross Insurance for Behavioral Health Care

Most people will need some type of behavioral health care at some point in their lives. For you it may be alcohol addiction treatment or depression management. To get the most out of your insurance policy, make sure you understand it. Know what is covered and what is not, what extra costs you face, and which providers are in your network. Find out if you need pre-authorization or a referral.

Good mental and behavioral health care is essential for living well, but too few people actually get the treatment they need. With Anthem Blue Cross you should find that you can get treatment and that the costs will not totally come out of your pocket. Working with your insurance company is an important part of getting good care, so don’t hesitate to call if you need help understanding and using your policy.

View the original article at thefix.com
3 May 2019
Cigna Behavioral Health Rehab Coverage for Addiction and Mental Illness

Behavioral health is a term that encompasses all types of mental illness, behavioral disorders and substance use disorders, or addictions. Rehab is an important treatment option for anyone struggling with one of these types of conditions, because it provides long-term, focused and individualized care. Cigna behavioral health rehab coverage is important to consider for anyone who needs this kind of treatment.

What Counts as Behavioral Health?

Medical terms can be confusing, especially when sorting through diagnoses, treatment options and insurance coverage. Behavioral health can refer to mental illnesses, like depression, anxiety disorders, personality disorders, schizophrenia and many others. Some childhood conditions are also a part of behavioral health, like attention deficit hyperactivity disorder, or ADHD.

Behavioral health most often refers to addiction. More formally known as substance use disorder, addiction is a behavioral and mental health condition that is characterized by out-of-control use of drugs or alcohol. While misusing substances is a choice, being addicted is not. Professional and medical treatment is necessary to help individuals overcome this disease and to be firmly in recovery with a lower risk of relapse.

Does Cigna Cover Substance Abuse Treatment?

The degree of coverage depends on individual plans, but yes, Cigna does cover treatment for substance use disorders. Some of the types of services covered are rehab for drugs or alcohol, detoxification and outpatient counseling.

Cigna also offers insurance holders important behavioral health and addiction resources. The free education series provides information about recognizing the signs of addiction as well as advice and helpful tips for both patients in rehabs and their families.

Patients with Cigna health insurance will need to find out if they meet the criteria to have rehab and other types of treatment for substance use covered. It is important for each individual to understand their plans, to know what the requirements are for coverage and to find out what any out-of-pocket costs might be.

Understanding Cigna Behavioral Health Rehab Coverage

The type of coverage a patient has for behavioral health and addiction depends on the plan purchased. It is important to understand coverage when making decisions about treatment. There are many factors to consider, including deductible amounts, whether or not treatment needs be with an in-network provider, whether coverage includes inpatient or outpatient services, if there is any coverage for after care services, and prescription drug costs and coverage.

Individuals should verify coverage and Cigna substance abuse policy before making a choice about treatment. There may be costs that have to be covered out of pocket, depending on individual plans and polices and the treatment chosen.

Cigna In-Network Providers vs. Out-of-Network Providers

One of the most important considerations to make when choosing treatment for addiction is between in- and out-of-network providers. Whether or not a patient needs to get treatment from an in-network provider depends on individual Cigna plans.

For instance, an EPO, or exclusive provider organization, is a type of insurance that requires patients only see treatment providers in the network. A PPO, or preferred provider organization, allows for treatment from providers outside of the network, but costs to the patient may be higher.

It is usually less expensive for the patient to choose treatment through an in-network provider. However, it is worth contacting Cigna to find out what is allowed and what extra costs would be. Sometimes an out-of-network rehab or therapist is the best option for a patient.

Types of Behavioral Health Treatment Covered by Cigna

Cigna substance abuse coverage includes two main types of treatment: inpatient and outpatient care. Outpatient treatment can be as simple as attending 12-step programs and support groups. However, for most people struggling with addiction, this is not enough.

Outpatient care provided by professionals is therapy or addiction counseling. Patients in outpatient treatment may have one or more sessions per week, but they don’t live in a rehab facility. They live at home and are generally able to continue with normal activities, like work and school, while going through treatment.

Inpatient treatment for addiction is also known as residential treatment or rehab. This type of care includes a stay for a month or a few months in a facility that provides 24-hour supervision and daily treatment. Inpatient treatment is best for people who have no safe place to live while getting treatment or who don’t feel confident in being able to stay sober while at home.

Both types of treatment offer one-on-one therapy for learning how to live without alcohol or drugs. Residential care, however, provides much more. Patients in rehab usually have access to medical care, alternative therapies, and family and group therapies. They benefit from a whole team of professionals with different types of behavioral health expertise.

Coverage for Aftercare Services

Aftercare is an important part of addiction treatment, and much of it is covered by Cigna insurance plans. For patients going through residential treatment, aftercare may include outpatient therapy sessions, support group attendance, check-ins back at the residential facility, job and vocational training and medical care.

This kind of ongoing treatment is important, because it provides patients with a smoother transition from the intensity of residential care to life back at home with little or no supervision. Aftercare helps to reduce the incidence of relapse and to minimize the need for additional inpatient treatment in the future.

Some of the types of aftercare that are likely to be at least partially covered by Cigna plans are outpatientsessions with Cigna therapists and potentially with out-of-network providers, prescription drugs and medication-assisted addiction treatment, and the costs of staying in a sober living house.

Cigna Mental Health Coverage

Mental health is typically included in coverage for behavioral health services. In fact, many patients have co-occurring mental illnesses and substance use disorders. The most effective treatment addresses all of the behavioral health needs of an individual. It is important to get a diagnosis that uncovers any substance use disorder or mental illness and to choose treatment services accordingly.

Cigna mental health criteria for coverage are having a diagnosis of a mental illness from a professional and recommended treatment plan. Patients who have been diagnosed are entitled to coverage for appropriate care. Like substance use disorders, this care may include residential treatment if necessary or outpatient therapy.

Types of Behavioral Health Services Cigna May Not Cover

Even with the highest level of Cigna behavioral health rehab coverage, there are some services that are not likely to be paid for by the insurance company. These will be out-of-pocket expense for the patients. Luxury rehab facilities, for instance, are probably not covered for any patient. A private room at a treatment center is also considered a luxury expense that is not typically covered.

The insurance plan will also not cover any medications that can be purchased over the counter. Many types of alternative or complementary services may also not be covered—things like yoga classes, music and art therapy, or massage.

Some of these services and treatments not covered can be beneficial. Patients should find out by contacting Cigna if coverage will be included before committing to them. Those who want to continue with services that are not covered must be prepared to pay the costs.

Finding the Best Behavioral Health Treatment

While Cigna behavioral health rehab coverage should not be the only consideration when choosing the best treatment, it should be an important one. Patients should start with in-network providers and look for a facility or therapist that is experienced and appropriate for the type of care needed. They can ask for references from previous patients and visit facilities to have a tour and to speak with staff before making a final choice.

The treatment a patient gets for addiction or mental illness is crucial to recovery and long-term wellness. It is not a decision that should be taken lightly. Each individual must choose the treatment that feels best and most comfortable but that also meets their needs and makes sense within a Cigna insurance plan and coverage level.

Using Cigna Insurance for Behavioral Health Care

In order to make the best use of Cigna insurance for getting needed treatment for addiction and other behavioral health issues, have a firm understanding of coverage. Patients should check with Cigna to confirm coverage and out-of-pocket costs. They also need to go over insurance plans with the treatment provider. These steps are important to take before committing to any treatment plan.

Most patients will not need a referral from Cigna to get treatment, but pre-authorization may be needed. Insurance holders will also need to cover any remaining deductible costs and copays associated with treatment.

Getting behavioral health treatment is so important and too often overlooked. Insurance holders have an ally with Cigna. This insurance company provides coverage options that work with most people’s needs and income levels. Working with Cigna is a crucial part of getting the best care that is also affordable.

View the original article at thefix.com

1 April 2019