Mental health benefits and coverage*

The plan covers the diagnosis and treatment of mental conditions on an outpatient or inpatient basis. Treatment may be provided by a psychiatrist, psychologist, psychotherapist, licensed nurse, mental health clinical specialist, licensed independent clinical social worker, mental health counselor, pediatric specialist or other providers as authorized by FCHP.

You may pay copayments for the services below; you also may be responsible for a deductible for certain services.

What's covered?

Service or procedure
Outpatient office visits, including individual, group or family therapy. The actual number of visits authorized is based on medical necessity as determined by FCHP.
Psychopharmacological services, such as visits with a physician to review, monitor and adjust the levels of prescription medication to treat a mental condition
Neuropsychological assessment services when medically necessary
Diversionary services such as day treatment/evening treatment and/or partial hospitalization for a full or partial day. Any of these services require authorization from the plan.
Room and board in a semiprivate room (or a private room when medically necessary) for respite, short-term residential, and hospital care only
The treatments and supplies that would ordinarily be furnished to you while you are an inpatient. These include, but are not limited to, individual, family and group therapies, pharmacotherapy, and diagnostic laboratory services.
Professional services provided by physicians or other licensed mental health professionals for the treatment of psychiatric conditions

What isn't covered?

Service or procedure
Treatment for personal growth, or other treatment that is not medically necessary
Evaluation and therapy for central auditory processing difficulties
Sensory integration therapy
Alternative therapies such as acupuncture, biofeedback and biofeedback devices for home use, neurofeedback, telephone, herbal, art, music or aquatic or massage therapy (when not provided by a network provider or physical therapist as part of your covered physical therapy benefit).
Ancillary services such as vocational rehabilitation, behavioral training, sleep therapy, employment or vocational counseling and training or educational therapy for learning disabilities
Psychological testing or neuropsychological assessments unless determined to be medically necessary
Elective long-term psychotherapy
Mediation or intervention services
Faith-based counseling (e.g., Christian counseling)

For details on your specific benefits, coverage, and copayments:

  • Refer to your Member Handbook, Benefit Summary or Schedule of Benefits
    or
  • Call our customer service department at:
    1-800-868-5200 (TDD/TTY: 877-608-7677), Monday through Friday, 8 a.m. to 6 p.m.

* Benefits and coverage may vary by product, plan design and employer.  For specific details regarding your FCHP plan, benefits and features, please check with your employer or contact a member of our customer service team at 1-800-868-5200 (TDD/TTY: 1-877-608-7677), Monday through Friday, 8 a.m. to 6 p.m. Eastern time.  MassHealth members can call FCHP Customer Service at: 1-800-341-4848 (TDD/TTY: 1-877-608-7677) Monday through Friday, 8 a.m. to 6 p.m.