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Covered in-plan services

Psychiatric outpatient services: Planned, regularly scheduled visits to a doctor, counselor or therapist to talk about your mental health issues.

Psychiatric partial hospitalization programs: Provided during the daytime hours, several days per week at a provider office. These services are planned and regularly scheduled. They include visits to a doctor, counselor or therapist to talk about your mental health issues. Some laboratory services are also covered if they are ordered by a psychiatrist in our network.

Psychiatric hospitalization: These services are the most intensive services available. This includes admission to a hospital for 24-hour care for a mental health or emotional condition.

Hospitalization usually occurs when you or your child:

  • Are at risk of harming yourself (him or herself) or others
  • Need close and continual checking of medications
  • Have tried other services tried in the community and they have not helped to solve the problems that brought you/them into service.

Targeted case management (Intensive Case Management, Resource Coordination, and Blended Case Management): A case manager works with you to help you get the services you need in your community. The case manager works to help you set and reach your goals.

Crisis intervention services: Can be used any time of day or night to help you in a crisis. These services keep you safe.  They help connect you to the people who can treat the problem until it has passed. Services can be provided by telephone or in person at almost any place in the community.

Clozapine (Clozaril) support services: Are provided by a psychiatrist or nurse to review how you are doing if you take the medication Clozaril. Services include regular office visits and laboratory tests. (Clozapine, Clozaril is a medication used to treat people who have Schizophrenia.)

Outpatient drug and alcohol services: Are provided in the community to help a person with alcohol or other drug problems. Services may include evaluation and/or individual or group therapy.

Methadone: Uses a specific medication therapy to treat addictions to opiates such as heroin or oxycodone.

Drug and alcohol detoxification, rehabilitation and halfway house services: These services help you stop using drugs and alcohol. If you need it, 24-hour care for alcohol and other drug problems is provided in a hospital or non-hospital setting

If you use these services you may or may not stay at the program overnight.

Behavioral health rehabilitation services (BHRS) for children and adolescents: Are available to children and adolescents.  They can be provided at home, school or in other community settings. (These services are sometimes referred to as "wrap around" services.)

Family-based mental health services: These treatment services are provided in the home for children, adolescents and their families.

Residential Treatment Facilities (RTF): Are a place where children and adolescents, under the age of 21, live while they are receiving inpatient treatment.

Specific services for children and adolescents

  • Behavioral health rehabilitation services (BHRS) for children and adolescents
  • Residential treatment facilities (RTF)
  • Family-based treatment

Supplemental services

As a rule, services that are not listed in the PerformCare Handbook are not paid for by PerformCare. However, it may be possible that PerformCare covers a service not listed.  You or your provider should contact Member Services with questions about coverage for a service that is not be listed in your Handbook.

Non-covered services

All services that are not specifically listed as In-Plan Services or are not approved Supplemental Services are not covered under your HealthChoices behavioral health program.

Other services available to you or your family

There may be other services and community supports available for you or your family. They may be provided through the County Mental Health and Drug and Alcohol programs in your area. PerformCare can help you get those services. We can help explore any costs that may apply to you.

The PerformCare staff works with other individuals and agencies to help organize your treatment and support. They include your primary care doctor, the Area Agency on Aging, and the Children, Youth and Family Social Service Provider.

For more information about your covered benefits, or for general help, call PerformCare using the member contact information for your county.