MENTAL AND NERVOUS DISORDERS

Under the Plan, treatment of mental health or psychiatric conditions is covered as shown in the Schedule of Benefits, with the following limitations:

1. Outpatient services limited to 20 visits per year, mental/nervous and counseling visits combined.
2. Benefits will not be covered unless Pre-Certification is obtained through the Plan at (800) 515-2073 (in an emergency, the Plan must be notified on the first working day after services are provided). The Plan has developed a team of mental health professionals to help you get the assistance you need in a timely manner.

What is a Mental or Nervous Disorder?

Mental or nervous disorder means conditions, illnesses, diseases and disorders listed in the most recent edition of International Classification of Diseases (ICD) as psychoses, neurotic disorders, and personality disorders; also other non-psychotic disorders listed in the ICD, to be determined by the Plan. A mental/nervous disorder includes any mental/ nervous disorder manifested by physical symptoms, any physical disorder manifested by mental/nervous symptoms, and any condition involving a combination of physical and mental/nervous causes and/or physical and mental/nervous symptoms.