It’s very common for people that struggle with mental health disorders to delay seeking help because they’re worried about the cost of treatment. This is why D’Amore Mental Health makes an effort to build strong relationships with many of California’s largest health insurance providers, including Health Net.
As one of Health Net’s in-network residential mental health services providers, we’re proud to make life-changing care more accessible to those who need it. Patients with a Health Net policy may be entitled to receive coverage for all, most, or a portion of the cost of their treatment.
This article goes over the resources available to help patients pay for quality inpatient mental health treatment under a policy from Health Net. For more information, fill out D’Amore Mental Health’s simple insurance verification form, and one of our admissions counselors can follow up to discuss the best coverage options.
How Health Net Covers Mental Health Services
Mental health is just as crucial to a person’s overall well-being as physical health, but this reality has only sometimes been reflected in the coverage provided by healthcare insurers. The Affordable Care Act has improved access by requiring all insurance companies in the healthcare marketplace to cover mental health and substance abuse disorders.
Under the law, mental health policies also have to be comparable to the coverage for physical health. This is in terms of co-pays, deductibles, visit limits, and other essential factors affecting quality care access.
Health Net provides these essential services through its subsidiary, Managed Health Networks (MHN), which is available as either a standalone policy option or as part of a comprehensive plan. The behavioral care benefits offered with an MHN plan can include both outpatient and inpatient services, depending on the levels of care the patient needs.
Outpatient Mental Health Services
This care category includes virtually all mental health services where the patient doesn’t stay in a medical facility overnight, including individual therapy, group therapy, family counseling, medication management, and support groups.
Inpatient Mental Health Services
Inpatient care is recommended during a mental health crisis where the patient needs a lot of support to help them recover and should be closely monitored by trained professionals. It consists of staying overnight at a residential facility for a period ranging from days to weeks or months, depending on the patient’s needs. Inpatient programs can include some of the same services as outpatient care but offer more comprehensive treatment and around-the-clock support.
Understanding Health Net’s Coverage For Mental Health Services
Health insurance policies are notoriously complicated. This leaves many patients unsure whether they can afford quality mental health services, especially in a crisis where they even need inpatient treatment in a residential facility. This confusion can cause unnecessary delays in getting help.
D’Amore Mental Health has a team of admissions counselors to help patients determine the coverage they’re eligible for and navigate the process of getting benefits. Our mission is to help all individuals suffering from mental health disorder access the care they need to get life back on track.
The most important factors affecting the coverage available for patients using a Health Net insurance plan include the following:
Meeting the Medical Criteria for Treatment
Health Net only provides coverage for mental health services considered medically necessary, according to specific criteria. Approved for a residential inpatient program begins with a referral from a qualified medical professional, such as the patient’s primary care doctor or therapist. After this initial referral, the intake process at D’Amore Mental Health includes an evaluation of the patient’s needs, which Health Net provides to support their application for benefits. Health Net’s case managers will review these assessments to determine whether to approve the patient’s treatment and for how long.
The insurance authorization process will typically take 5-7 days, but it’s also possible for them to request more information before making a decision. The team at D’Amore Mental Health will work closely with the insurer’s representatives to get as much coverage as possible for the patient’s situation.
The Terms of your Specific Policy Tier
Once you get approved for benefits, the out-of-pocket costs associated with getting treatment may also depend on your policy tier. Patients signed up for a plan with a lower monthly payment will typically have to pay for a higher percentage of their care.
Health Net has four different tiers available for mental and behavioral health:
- Bronze: Patients pay 40 percent
- Silver: Patients pay 30 percent
- Gold: Patients pay 20 percent
- Platinum: Patients pay 10 percent
In Network vs. Out of Network
Health Net’s benefits for mental and behavioral health services can also vary based on whether the patient chooses a treatment center that’s part of their network of approved providers. Getting authorized for coverage at an out-of-network provider is much less common so the out-of-pocket costs could be much higher. D’AMore Mental Health is part of Health Net’s behavioral health network, which makes the authorization process a lot smoother for our patients that use this insurer.
Find the Help You Need at D’Amore Mental Health
At D’Amore Mental Health, patients are much more than just their diagnosis. As one of Southern California’s leading residential mental health treatment providers, we’re committed to providing patients with personalized, evidence-based care during a crisis. Our program has a three-to-one staff-to-patient ratio, which creates a supportive environment for learning effective coping skills and becoming more empowered.
While inpatient mental health treatment can be expensive, the health benefits available in your Health Net policy can lower your out-of-pocket expenses. We work with all patients to help them save money without sacrificing the quality of care.
Our admissions team can answer questions about the medical criteria needed for our program, the billing process, and how patients can receive all the financial help they’re entitled to. Don’t allow fears about the financial burden of getting treatment to get in the way of making progress with difficult mental health challenges.