Duke HR - Health & Dental Benefits

Fill out the Out-of-Network Claim Form and mail it to:

Cigna Behavioral Health
PO Box 46270
Eden Prairie, MN 55344

Claims must be submitted within 180 days of date of service.

Mental Health and Substance Abuse Benefits

Duke offers both outpatient and inpatient mental health and substance abuse benefits under each of our health plans. Beginning January 1, 2008, all mental health and substance abuse benefits will be administered by CIGNA Behavioral Health.

To find a network provider, call CIGNA Behavioral Health toll-free at 1-888-253-8552 or log on to the CIGNA Behavioral Health web site.

Employer ID: Duke
PIN: employee

Plan Chart

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

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

"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.