Behavioral Health Benefits

AmeriHealth Caritas Next’s affordable health care plans provide access to whole person care, including behavioral health care.

Behavioral health care includes mental health (your emotional, psychological, and social well-being) and substance (alcohol and drugs) use disorder treatment and rehabilitation services. All AmeriHealth Caritas Next members have access to services to help with mental health issues like depression or anxiety, or to help with alcohol or other substance use disorders.

Enrollees experiencing a mental health crisis can call the national Suicide and Crisis Lifeline at 988.

If you are in danger or need immediate medical attention, call 911.

Behavioral health services (mental health and substance use disorder services)

These services may require preauthorization. Call Member Services at 1-833-590-3300 (TTY 711) to learn which services require preauthorization, or if you have any questions about behavioral health benefits.

Mental and behavioral health services

  • Mental/behavioral health outpatient office visits
    • Mental health or substance dependence assessment
    • Diagnostic testing/assessment
    • Psychological testing
  • Mental/behavioral health outpatient non-office services
    • Outpatient rehabilitation services in individual or group settings
    • Day treatment programs
    • Outpatient opioid treatment
    • Ambulatory detoxification
  • Mental/behavioral health inpatient services facility fees
  • Mental/behavioral health inpatient services physician or surgeon fees
    • Emergency care
    • Psychiatric inpatient hospitalization
    • Partial hospitalization
    • Short‐term partial hospitalization
    • Mobile crisis management
    • Professional treatment services in facility‐based crisis programs (following the initial seven days/112 units)
    • Medically supervised alcohol or drug use treatment center detoxification crisis stabilization/ Alcohol and Drug Abuse Treatment Center (ADATC; following first eight hours of admission)
    • Electroconvulsive therapy

Chemical dependency/substance use disorder services

  • Chemical dependency/substance use disorder outpatient office visits
    • Mental health or substance dependence assessment
    • Diagnostic assessment
  • Chemical dependency/substance use disorder outpatient non-office services
    • Medication‐assisted treatment (MAT)
    • Nonhospital medical detoxification
    • Medication management when provided in conjunction with a consultation
  • Chemical dependency/substance use disorder inpatient services facility fees
  • Chemical dependency/substance use disorder inpatient services physician or surgeon fees
    • Detoxification and related medical services when required for the diagnosis and treatment of addiction to alcohol and/or drugs

Finding a behavioral health care provider

You can find a health care provider for behavioral health services by:

  • Searching our online provider directory
  • Asking your primary care provider (PCP) for a referral
  • Calling AmeriHealth Caritas Next Member Services at 1-833-590-3300 (TTY 711)

If you have any questions about behavioral health services, or if you believe you need access to more intensive behavioral health services — like psychiatric residential treatment facilities or assertive community treatment — that your plan may not provide, talk with your primary care provider or call Member Services at 1-833-590-3300 (TTY 711), Monday through Friday, 8 a.m. to 8 p.m.