Behavioral health

You have unlimited mental health outpatient visits. Some services need prior authorization. You’re covered for services including: 

• Psychological testing 
• Mental health provider visits
• Partial hospitalization 
  
• Intensive outpatient therapy 
• Medication management  

If your child is diagnosed with a severe mental health condition or developmental disability (ex: schizophrenia, autism), you may qualify for extra benefits and services. These benefits may have different limitations. Just call

Member Services at 1-800-822-2447 (TTY: 711) to learn about eligibility and benefit limits.

If you think your child has a drug or alcohol problem, we can help. We cover treatment services including:

• Inpatient detoxification
• Non-hospital residential treatment 
• Outpatient drug or alcohol treatment 

Learn more about substance use disorder  

Check out our new no cost Behavioral Health program to support Tweens, Teens and their Guardians.

• Pyx Introduction Letter (PDF)
• Pyx Tweens & Teens Flier (PDF)
• Pyx Guardian Flier (PDF)

Your copays for behavioral health services usually depend on the type of CHIP coverage plan you have: free, low-cost or full-cost. In some cases, your copay may depend on the type of service you get. Here are some details:

Autism spectrum disorder diagnosis:

• No copays for all CHIP plans due to Act 62: The Autism Insurance Act (PDF)

Autism spectrum disorder services:

• Free CHIP: no copay
• Low-cost CHIP: copay based on service type
• Full-cost CHIP: copay based on service type

If you have questions about the costs of certain autism spectrum disorder services, just call us at 1-800-822-2447 (TTY: 711).

Inpatient hospital or rehabilitation stays for mental health or substance use:

• Free CHIP: no copay
• Low-cost CHIP: no copay
• Full-cost CHIP: no copay

Visits to specialist providers:

• Free CHIP: no copay
• Low-cost CHIP: $10 copay
• Full-cost CHIP: $25 copay

Learn to manage stress

Did you know that stress can affect your health? It can be hard to keep up with healthy habits during times of stress.

You can read these articles to learn more about mental and emotional well-being:

• Understanding depression
• Healthy living resources
• 4 ways to take care of physical and mental well-being during unsettled times

Or learn more about depression from the National Institute of Mental Health.

Substance use disorders happen when people misuse drugs, alcohol or both, repeatedly. Often, substance use is related to mental health.

Learn more about substance use disorders

Or find more info from:
 

• Alcoholics Anonymous®
  
• Substance Abuse and Mental Health Services Administration (SAMHSA)
  

Mental health disorders can be serious. They can change a person’s thinking, feeling, mood and daily functioning. And each year they affect 1 in 10 children. 

Some examples of mental health disorders include:

• Depression

• Schizophrenia

• Bipolar disorder

• Attention-deficit/hyperactivity disorder (ADHD)

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD)

• Anxiety

• Borderline personality disorder

For more info, visit the National Alliance on Mental Illness (NAMI) website.

There, you can learn about the different support programs NAMI offers, including:

• StrengthOfUs.org 
  An online social community for teens and young adults living with mental illness. It’s a place for them to connect and learn about services.
• Peer-to-Peer 
  A no-cost course for adults living with mental illness. Those who join can learn about coping skills and self-care.
• Find Help

Use this search tool to get help finding free or reduced-cost resources, including food and supplies, housing, health and wellness services, and legal services.

• Pennsylvania Opioid Addiction Services
• Check these resources for even more support. You can learn about everything from quitting nicotine to getting rides to your health visits.