Does Carelon (Beacon) Behavioral Insurance Cover Mental Health Therapy Treatment Programs?

A MISSION FOR MICHAEL

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For those who are experiencing mental health challenges, therapy sessions and personalized support can help you learn to manage your symptoms effectively. Therapy sessions can highlight mental health awareness, self-care practices, and use various psychotherapy techniques. A Mission For Michael (AMFM) provides residential treatment options for moderate to severe mental health disorders in California, Washington, and Virginia.

AMFM mental health support is ideal for those living with a range of mental health conditions including mood disorders, depression symptoms, anxiety disorders, trauma-related conditions, and some dual diagnosis conditions. Our mental health support focuses on the whole person, not just your mental health symptoms. We have found that using this holistic approach leads to greater improvements in emotional well-being and psychological health. We will shift gears to explore what Carelon covers for mental health treatment. For many, health coverage makes mental healthcare accessible and affordable.

Who is Carelon Behavioral Health Insurance?

Carelon Behavioral Health Insurance was formed in 2022, though its business roots can be traced back over 150 years. Carelon provides various services including pharmacy benefits, behavioral health, palliative care delivery, medical benefits management, care navigation, and research.

Carelon offers healthcare packages that allow members to access behavioral health services, including crisis services, behavioral health needs, wellness needs, and prevention efforts. Carelon prides itself on providing personalized support that operates with a holistic lens. This can help you improve your quality of life and overall emotional well-being.

A Carelon health policy can provide you with coverage for a range of mental health resources and treatments. This commonly includes therapy and counseling services in both inpatient and outpatient treatment settings. Health plan options with Carelon are designed to make accessing mental health treatment affordable and accessible.

Carelon provides services that benefit individuals, health plans, employers, providers, government agencies, and life science companies. Your health benefits can include coverage options for preventative and holistic treatments. To support understanding your health benefits, complete the AMFM insurance verification form. This provides us with the information needed to contact Carelon and inquire about the details of your healthcare coverage.

Private medical insurance can include healthcare coverage for behavioral health services including therapy, counseling, psychiatric care, and other mental health resources. Insurance coverage can cover some, if not most, of the cost of behavioral health services that are deemed medically necessary.

Health insurance providers tend to offer an assortment of healthcare policies so that their policyholders can choose coverage that aligns with their medical and mental health needs, and their budget. This can lead to variations in coverage rates and out-of-pocket expenses including health insurance premiums, deductibles, and copayments. Additionally, your plan may require choosing providers from within their health insurance network. Out-of-network providers may not be covered by your health benefits, depending on your policy details. If you have been struggling with worsening, or persistent, mental health challenges, we encourage you to contact AMFM for a confidential and complimentary mental health assessment. Our staff will provide you with a personalized treatment recommendation based on your current symptoms and psychological symptoms.

Beacon Health Options transitioned into Carelon Behavioral Health after a merger in March 2023. When this merger occurred, the services of Beacon Health were continued under the name of Carelon Behavioral Health. This transition helped enhance their products and services, as well as integrated care models. Carelon has an additional focus on coordination and treatment option advancements.

If you were previously a Beacon Health Options member and would like to learn more about how this transition affected your health benefits, we encourage you to contact AMFM Mental Health Treatment Centers today.

Approximately 59.3 million adults in the United States, or 23% of the population, lived with a mental illness in 2022, according to the National Institute of Mental Health (NIH). Nearly half of all mental health disorders emerge by age 14, and 75% show symptoms by age 24. Serious mental health crises, including suicide, remain a pressing concern, with over five percent of adults reporting serious suicidal thoughts in 2022.

Depressive disorders, such as major depression, dysthymia, and bipolar disorder, affect about nine percent of U.S. adults annually, with women twice as likely as men to experience major depressive episodes. Emergency departments saw over five million visits related to mental health, behavioral, or neurodevelopmental disorders in 2021, highlighting the critical need for accessible and effective mental health care.

The National Alliance on Mental Illness (NAMI) noted that the most common mental health conditions among adults in the U.S. include:

  • Anxiety Disorders
  • Major Depressive Episodes
  • Post Traumatic Stress Disorder (PTSD)
  • Bipolar Disorder
  • Borderline Personality Disorder (BPD)
  • Obsessive Compulsive Disorder
  • Schizophrenia

Checking My Carelon Behavioral Health Insurance Coverage at AMFM

The simplest way to learn about the details of your health benefits is to contact AMFM Mental Health Treatment Centers and verify your insurance. Our admission counselors have worked with Carelon health plan options and are familiar with their health plans. We can walk you through the details of your policy, enabling you to make an informed treatment decision.

Alternatively, you can review your policy documents focusing on information related to behavioral health coverage. For those who would like to learn about the cost of residential treatment without the use of insurance, we can review available ways to pay for treatment. Call us today to speak with an AMFM admission counselor for personalized support and guidance.

Does Carelon Insurance Cover Mental Health Therapy and Treatment?

Yes, Carelon commonly provides coverage for mental health therapy and treatment services. This typically includes individual therapy, group therapy, psychiatric care, and medication management services. Treatment can include the use of evidence-based approaches including behavioral therapy, cognitive behavioral therapy, and dialectical behavioral therapy.

The details associated with coverage are dependent on the details of your health plans. Your plan may require out-of-pocket expenses in the form of health insurance deductibles, copayments, and premiums. For further information about the scope of your health benefits, contact AMFM today.

Treatment Centers Near Me That Accept Carelon Behavioral Insurance Plans

A Mission For Michael (AMFM) offers residential treatment programming for a range of mental health conditions. We focus on providing whole-person care, addressing the different areas of your life that have been affected by your mental health conditions. This can include a range of therapies, wellness programs, and holistic treatments. Dial (866)478-4383 to learn about available high-end accommodations.

Mental Health Treatment Programs Covered by Carelon Behavioral Insurance

Carelon covered therapy near you can include a range of treatment services. This allows you to receive personalized care for a range of psychiatric conditions. Treatment services can incorporate stress management and coping strategies to help you effectively manage your mental health symptoms. Continue reading for a general overview of commonly used programs with Carelon health plans.

Carelon Behavioral Coverage for Residential Treatment Programs

Residential treatment programs are ideal for those experiencing moderate to severe mental health disorders. These programs provide around-the-clock professional support and guidance. Treatment typically includes psychotherapy techniques, therapy sessions, and holistic treatments. Psychiatric care and medication management services are often available. Carelon's health coverage typically includes coverage for residential treatment programs. Your plan may include out-of-pocket expenses in the form of health insurance deductibles, copayments, and premiums.

Carelon Behavioral Coverage for Intensive Outpatient Program

Intensive Outpatient Programs (IOPs) are an outpatient treatment option that provides flexible treatment. This generally includes several hours of group therapy, supplemented with individual therapy sessions. IOPs near you may be available in the morning and evening hours to accommodate your work or academic schedule. These programs can be impactful for those who have completed a higher level of care. Carelon health plans typically include coverage options for IOPs. We encourage you to review the details of your health policy to learn about your expenses, such as health insurance copayments, premiums, and deductibles.

Carelon Behavioral Coverage for Outpatient Program

Outpatient treatment programming is a flexible treatment option for those who are experiencing mild to moderate mental health disorders. Outpatient treatment is customizable, including a range of treatment options. Depending on your needs, this can include individual or group therapy and medication management services. This is ideal for those who require continued support for mild symptoms in their home environment. Carelon health plan options typically include outpatient treatment services, including psychiatric care and medication management services. Your healthcare coverage may require prior authorization for continued care.

Carelon Behavioral Coverage for Partial Hospitalization Programs

Partial Hospitalization Programs (PHPs) can provide intensive treatment during the day while you reside at home. This is ideal for those who don’t require around-the-clock care and support. PHPs can include a range of psychotherapy techniques, therapy sessions, and mental health support to improve your cognitive functioning. PHPs can ease the transition from a higher level of care. Carelon healthcare coverage often includes partial hospitalization programs when it is medically necessary. You may be required to obtain prior authorization to process your health insurance claims.

What Disorders Does Carelon Health Insurance Cover?

Health coverage through Carelon can include many mental health disorders, occurring in a range of severities and dual diagnosis conditions. Your coverage is dependent on the details of your health policy and the severity of your symptoms. Continue reading for a brief overview of some conditions included in Carelon’s medical coverage, keeping in mind that this list is not exhaustive.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder commonly known for causing inattention, impulsivity, and hyperactivity. This condition often begins during childhood and can continue through adulthood. Adults living with ADHD often notice its effects on their social relationships and professional performance. Treatment for ADHD commonly includes behavioral therapy and medication management services.

Carelon health care policies often include coverage for ADHD treatment, including therapy and medication management. Your plan may require that you see providers within your health insurance networks.

Depression is a mood disorder that can occur with a range of symptoms and severities. Common depression symptoms include persistent sadness, loss of interest, fatigue, diminished concentration, and isolation. You may find that your symptoms affect your physical health, relationships, and work performance. Depression treatments commonly include therapy sessions and medication management services.

Your Carelon health plan can include treatment options like therapy and medication. Treatment commonly includes evidence-based therapies like cognitive-behavioral therapy (CBT).

Bipolar-related disorders, including cyclothymia, are known for extreme mood swings, ranging from manic episodes to deep depression. Bipolar-related disorders can range in severity and treatment options. Those experiencing manic or severe depressive symptoms may require residential treatment. Outpatient treatment can be helpful for those who are managing their symptoms while navigating their day-to-day life. 

Your Carelon health policy can include coverage for bipolar and bipolar-related wellness and mental health treatments. This can include residential treatment, outpatient care, and psychiatric care.

Borderline Personality Disorder (BPD) is known for causing intense or overwhelming emotions, impulsivity, and difficulty within personal relationships. These symptoms can lead to significant distress and life impairment, including patterns of unhealthy relationships. Those living with BPD often benefit from long-term mental health treatment ranging from residential to inpatient care, with psychiatric care in some services. 

Carelon health plan options typically include BPD treatments, including Dialectical Behavior Therapy (DBT). Coverage can include both inpatient and outpatient care.

There are several anxiety disorders, including Generalized Anxiety Disorder (GAD), panic disorder, and social anxiety disorder. These conditions are known for causing excessive worry and panic that are difficult to control. You may also experience physical symptoms including tension. Anxiety symptoms can affect your relationships, professional performance, and daily routine.

Carelon health plans can include anxiety treatments, including therapy and medication management services.

Post Traumatic Stress Disorder (PTSD) is a trauma-related disorder that can develop after experiencing or witnessing a trauma. You may experience nightmares, anxiety, flashbacks, and hypervigilance. PTSD can range in severity and recommended treatments. You may require psychiatric care, residential treatment, or outpatient services to effectively manage your symptoms.

Carelon healthcare coverage typically includes PTSD treatment like trauma-focused therapies like CBT and EMDR. Your coverage can include individual, group, and family therapy.

Psychosis is known for causing a disconnection from reality and can involve symptoms including hallucinations, delusions, and disorganized thinking. Psychosis is commonly associated with conditions like schizophrenia and severe mood disorders. Those experiencing active psychosis often require intensive, comprehensive care.

Carelon’s health coverage often includes treatment for psychosis, including residential treatment and psychiatric care.

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    Find out about our free assessments and admissions process

    We accept most major insurance providers and can check your coverage levels for you.

    If we are not an appropriate provider for care, we will assist in finding a care provider that can help. 

    Does Carelon Health Insurance Cover Dual-Diagnosis Treatment Near Me?

    Yes, Carelon’s medical insurance often includes coverage for dual diagnosis treatment. This can include residential and outpatient treatment services, depending on the severity of your symptoms. This is the preferred treatment approach for those experiencing more than one mental health condition because it provides simultaneous care for complex psychiatric conditions.

    The health benefits associated with your plan can vary from others, which is why we recommend that you verify your coverage to learn about the scope of your insurance coverage. Contact AMFM Mental Health Treatment Centers today for support and guidance.

    Psychiatrist writing notes while having therapy session with a patient.

    How Much Does Carelon Cover For Therapy and Other Mental Health Treatments?

    If Carelon covers mental health treatment near you, your out-of-pocket expenses can vary. Carelon offers various health benefits, allowing you to choose a health plan that aligns with your medical and mental health needs. Health coverage can include coverage for a significant portion of your treatment expenses.

    If you’re interested in learning about additional health policy options with Carelon, we encourage you to explore your plan options during your health insurance enrollment period. You can contact Carelon directly for health insurance quotes to determine if another plan would fit your needs. Changes can generally be made during health insurance open enrollment periods.

    Carelon Health Plan typically provides coverage for mental health treatment based on the details of your plan. Some plans may have specific session limits or number of treatment days. These limits may apply to residential treatment and outpatient programs like partial hospitalization programs or intensive outpatient programs.

    If you find yourself needing treatment beyond the limits associated with your health policy, you may need to request a pre-authorization. This is done before you receive additional care, and can vary for each individual. Your authorization will examine your current psychological health, previous gains in treatment, and your requested treatments.  Our admission counselors can support you in this, and help you submit the required documentation for a prior authorization.

    • About half of those who develop a mental health disorder by the age of 14, whereas 75%  have noticeable symptoms by the age of 24. 
    • The National Institute of Mental Health (NIH) estimated that 59.3 million adults were living with a mental illness in 2022. This equates to 23% of adults living in the United States.
    • Over five percent of adults in the U.S. reported experiencing serious thoughts of suicide in 2022. The rate of deaths due to suicide was at its peak in 2022.
    • About nine percent of adults in the U.S. experience a depressive disorder each year. This includes major depression, dysthymia, and bipolar disorder. Women are twice as likely to experience major depressive disorder compared to men.
    • The Centers for Disease Control and Prevention (CDC) reported that there were over five million emergency department visits related to mental health, behavioral, or neurodevelopmental disorders in 2021. 

    Check if your health insurance will cover the cost of mental health treatment.