All four Health Plan Levels - Ultimate, Best, Better and Basic have the same behavioral health benefits with identical cost sharing. Members of the health plan receive 5 free counseling sessions either with a LAMP Advocate or an in network community provider (including Teladoc). The behavioral health benefit is 42 combined therapeutic and psychiatric behavioral health services per calendar year. Please note, 5 free sessions with a LAMP Advocate are also available to employees who are not health plan members.
The plan benefit pays according to the place of service: LAMP Office, In-Network Provider (Aetna Choice POS II Open Access) or Non-Network Provider.
Residential and Rehabilitation services for behavioral health and substance abuse are not a covered benefit.
LAMP Office Services:
Counseling - Member is responsible for $15 co-pay per office visit AFTER the 5th office visit.
Psychiatric Services - Member is responsible for $15 co-pay per office visit AFTER the 1st office visit.
In-Network Provider Services (includes Teladoc):
(Manatee YourChoice - Aetna Choice POS II Open Access)
Counseling - Member is responsible for $25 co-pay per office visit AFTER the 5th office visit.
Psychiatric Services - Member is responsible for $25 co-pay per office visit.
Non-Network Provider Services:
Out of Network Benefits for Therapy and Psychiatry.
Precertification is NOT required for outpatient therapy or psychiatry.