Mental Health and Substance Abuse Benefits
Duke offers both outpatient and inpatient mental health and substance abuse benefits under each of our medical plans. Mental health and substance abuse benefits are administered through Cigna Behavioral Health.
In adherence to the federal Mental Health Parity regulations, Duke has removed the limits on inpatient and outpatient mental health care from in-network providers for all four medical plans.
For Duke Options, the limit on out-of-network visits has also been removed. However, out-of-network visits under Duke Options beyond 20 per calendar year will require approval by a case manager.
Mental Health Providers
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). You can also browse a list of Duke mental health providers that are considered network providers for Duke employees and their dependents
Cigna Fill out the Cigna Out-of-Network Claim Form and mail it to:
Cigna Behavioral Health
Attn: Claims Service Dept.
P.O. Box 188022
Chattanooga, TN 37422
Claims must be submitted within 180 days of date of service.
Details about mental health and substance abuse benefits are outlined below.
|Duke Select (HMO)||Duke Basic (HMO)||Blue Care (Blue Cross Blue Shield HMO)||Duke Options (Blue Cross Blue Shield PPO)|
|Cigna Behavioral Health|
|Outpatient||Covered in full after $20 co-pay for individual/family therapy ($25 for Duke Basic)
||After $500 annual deductible, plan pays 70% of allowable charge1|
|Limit of 20 visits per calendar year for Duke Select, Duke Basic, and Blue Care participants|
|Precertification required for psychological testing, electroshock therapy, and hypnosis||Precertification required for psychological testing, electroshock therapy, and hypnosis|
|Inpatient||Co-pay of $450 per admission
||70% after $700 per admission co-pay and deductible|
|Limit of 20 days per calendar year for Duke Select, Duke Basic, and Blue Care participants|
|Must be precertified prior to admission||Must be precertified prior to admission|
|For Duke Options, the out-of-network deductible and co-insurance maximum will be consolidated with medical claims|
- All payments are based on the allowable charge. You are responsible for charges over the allowable charge when receiving out-of-network services.