2009 Mental Health Benefits

For Incentive PPO, Purdue 500, and UnitedHealthcare medical plans

Administered by UMR (Incentive PPO and Purdue 500) and UnitedHealthcare.

Purdue University is committed to helping faculty, staff, and their covered dependents achieve and maintain good mental and physical health. To empower employees to enhance their mental health and sense of well-being, Purdue provides special mental health benefits on the Incentive PPO, Purdue 500, and UnitedHealthcare medical plans.

No deductible applies to outpatient services obtained from an in-network provider. In addition, the first eight in-network mental health visits per calendar year are covered at 100 percent. Visits 9-30 are covered at your medical plan’s usual in-network coinsurance or copay, but these visits are still free from the deductible.

Out-of-network mental health care is subject to the same deductible and coinsurance or copay as other out-of-network services covered under your plan.

What types of situations and conditions are covered

Mental health benefits under Purdue’s medical plans may be used for the treatment of clinical mental illness and for counseling and care related to stressful situations you are experiencing. For example, marriage or child-rearing problems, grieving over the loss of a loved one, and work-related stress are all eligible for mental health benefits under the Purdue medical plans.

Who may provide coverage

To be eligible for coverage, mental health benefits must be provided by any of the following state-licensed, board-certified providers:

Psychiatrists
Clinical psychologists
Members of the Academy of Certified Social Workers (ACSW)
Licensed clinical social workers (LCSW)
Licensed mental health counselors (LMHC)
Licensed marriage and family therapists (LMFT)
Licensed Professional Counselor
Certified Addiction Counselor (for substance abuse)

The provider designations listed above are used in the state of Indiana. To be eligible for coverage, providers outside Indiana must qualify as a behavioral health practitioner under the following definition:

Behavioral Health Practitioner: A psychiatrist, psychologist, or a mental health or substance abuse counselor or social worker who has a master's degree, and who is legally licensed and/or legally authorized to practice or provide service, care, or treatment of behavioral health disorders under the laws of the state or jurisdiction where the services are rendered; and acts within the scope of his or her license; and is not the patient or the parent, spouse, sibling (by birth or marriage), or child of the patient.

Services for mental health, substance abuse, and chemical dependency

	Purdue 500	Incentive PPO	UnitedHealthcare
Maximum Inpatient Treatment per calendar year	20 days	20 days	20 days
Maximum Outpatient Treatment per calendar year	30 visits	30 visits	30 visits
Substance Abuse and Chemical Dependency Maximum Benefit per Lifetime	$75,000	$75,000	$75,000
Deductible: Individual In-Network Individual Out-of-Network * Family In-Network Family Out-of-Network *	None $500 * None $1,000 *	None $800 * None $1,600 *	None $500 * None $1,000 *
Outpatient Employee Coinsurance: In-Network Out-of-Network	Visits 1-8: 0% Visits 9-30: 30% 30%	Visits 1-8: 0% Visits 9-30: 15% 40%	Visits 1-8: $0 Visits 9-30: $20 30%

* Out-of-network mental health, substance abuse, and chemical dependency claims are subject to the same deductible as other out-of-network care. The amounts listed above represent the combined annual deductible for all out-of-network care covered under the plan (both mental health and non-mental health expenses). They do not represent a separate mental health out-of-network deductible.

More details

In-network office visits for medicine checks related to mental health treatment are paid at 100 percent with no deductible and no coinsurance or copayment. These office visits do not count toward the annual 30-visit maximum. Out-of-network office visits for medicine checks are subject to the same deductible and coinsurance or copayment as any other out-of-network care.
Psychological testing, for example, testing done for attention deficit disorder, is not covered by the mental health benefit. It is covered under the medical portion of your health plan.

Employee Assistance Program: Expert guidance

Purdue’s Employee Assistance Program has been helping University employees and their families for more than two decades, and the program is as valuable today as it has ever been. EAP counselors are well-acquainted with local mental health care professionals and can help guide you to the one who is most appropriate for your situation and your personality.

If you visit with an EAP counselor, she will thoroughly assess your situation, perhaps identifying issues that you may not even be aware of yourself. EAP counselors will then help you find the right care provider and think through important questions you will want to ask when you go for your first appointment.

Although you are not required to work with an EAP counselor before seeking mental health benefits under your Purdue medical plan, experience shows that patients have better results when a qualified professional helps guide them through the process.

EAP counselors are also valuable resources for dealing with workplace issues, such as problems related to your supervisor or your co-workers.

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