Duke HR - Open Enrollment 2009

Open Enrollment 2009

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Box 90496
Durham, NC 27705
(919) 684-5600

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HR Home >> Benefits >> Open Enrollment 2009 >> Mental Health & Substance Abuse Benefits

BENEFITS OPEN ENROLLMENT 2009

Mental Health and Substance Abuse Benefits

Duke offers both outpatient and inpatient mental health and substance abuse benefits under each of our health plans. To find a network provider, call CIGNA Behavioral Health toll-free at 1-888-253-8552 or log on to their web site (Employer ID: Duke, PIN: employee).

Details about these benefits are outlined in the chart below:

	Duke Select (HMO)	Duke Basic (HMO)	Duke Options (Blue Cross Blue Shield PPO)	Blue Care (Blue Cross Blue Shield HMO)
	CIGNA Behavioral Health
	In-Network		Out-of-Network
Outpatient	Covered in full after $35 co-pay per visit for individual/ family therapy		$100 annual deductible You pay 50% UCR^1,4 costs
	Limit of 20 unmanaged^1,2 visits per calendar year		Limit of 20 visits per calendar year²
	Precertification required for psychological testing, electroshock therapy, hypnosis		Precertification required for psychological testing, electroshock therapy, hypnosis
	Lab and outpatient charges and ECT, you pay 20%⁴		Lab and outpatient charges and ECT, you pay 50% after deductible^1,4
Inpatient	You pay 20% after $250 annual deductible		You pay 50% of UCR^1,4 after $250 per admission co-pay
	$1,000 annual out-of-pocket maximum		Alternative care limited to non-residential programs
	Limit of 30 days per calendar year		Limit of 20 days per calendar year³
	Must be precertified prior to admission		Must be precertified prior to admission

"Unmanaged" means that no precertification is required. However, precertification is required for psychological testing, electroconvulsive therapy (ECT), and hypnosis.
The limit of 20 visits for outpatient in-network and out-of-network benefits is combined.
The limits for inpatient in-network and out-of-network benefits are combined and not mutually exclusive.
All payments are based on the usual, customary, and reasonable (UCR) allowable charge. You are liable for charges over UCR when receiving out-of-network services. For a definition of UCR, see the glossary.

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