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Behavioral health can affect overall health. We want to help members get quality care for their mind and body. Behavioral health services are meant to help those facing:
Sometimes, one or more of these conditions may exist at the same time. Or they may exist in addition to a physical condition.
The type of service needed depends on the situation. A Care Coordinator can help members find out what services are covered. He or she can also let you know if the service will need prior authorization (to be approved before you go for the service). If you need a Care Coordinator, call 1-877-232-5518.
The Behavioral Health Care Guidelines have been updated. See the current Level of Care Guidelines for Centennial Care. If you have questions about these guidelines, ask your doctor or Care Coordinator.
What is covered?
Here are just some of the services covered by this plan:
|Covered Service||Applies to:||Does service need prior authorization?|
|Inpatient Psychiatric Hospital Services||All ages||Yes|
|Inpatient Professional Services||All ages||No|
|Outpatient Hospital Services||All ages||No|
|Psychological Testing||All ages||No|
|Therapy||All ages||No, but services beyond core coverage may need prior authorization|
|Intensive Outpatient for Substance Abuse and Co-occurring Disorders||All ages||No|
|Residential Treatment Center (RTC)||Under age 21||Yes, and services beyond core coverage may need prior authorization|
|Day Treatment Services||Under age 21||No|
|School Based Counseling||Under age 21||No|
|Pharmacy Services||All Ages||May be required based upon the drug prescribed|
You do not need a referral from your PCP to get these services. For a complete list of covered services, see the Member Handbook.
What is not covered?
Examples of services this plan does not cover include:
For more information about behavioral health benefits, see the Member Handbook.
New Mexico Crisis and Access Line (NMCAL)
NMCAL is available to New Mexicans during a mental health crisis. Use this state-wide toll-free phone line to access local help and resources. There are mental health professionals ready to help 24 hours a day, 7 days a week.
Call NMCAL at 1-855-NMCRISIS (1-855-662-7474).
If you have a life-threatening emergency, please call 911.