Carelon Healthcare Services Mental Health Coverage in Tennessee

Does Carelon Healthcare Services Insurance Cover Mental Health Treatment?

Yes, Carelon Healthcare Services insurance in Tennessee may cover mental and behavioral health services depending on your insurance plan’s benefits and individual needs. Their insurance plans encompass a wide array of psychiatric services tailored to mental health care, ensuring that individuals receive the holistic mental health care they need. This includes coverage for behavioral therapy and cognitive-behavioral therapy (CBT), which are both integral parts of many mental health treatment plans.

Carelon’s dedication to a whole-person approach means that their insurance also covers non-medical counseling, further emphasizing their commitment to comprehensive mental health care.

How to Check Your Carelon Healthcare Services Mental Health Coverage Levels

Athena Care is in-network with most major insurance plans. Find out more about your insurance coverage by calling your insurance company or by contacting us below. One of our care coordinators can help you navigate your insurance coverage to get the care you need.

Jump to Section

• How to Check Your Carelon Healthcare Services Mental Health Coverage Levels
• Which Mental Health Services Are Covered by Carelon Healthcare Services Insurance?
• Which Mental Health Conditions Are Covered by Carelon Healthcare Services Insurance
• Which Mental Health Treatment Are Covered by Carelon Healthcare Services Insurance
• How To Find Mental Health Services Near Me in Tennessee
• About Carelon Healthcare Services Health Insurance
• Does Carelon Healthcare Services Health Insurance Cover Online Therapy
• How Much Do Mental Health Services & Testing Cost

Which Mental Health Services Are Covered by Carelon Healthcare Services Insurance?

Carelon Healthcare Services Insurance covers a range of mental health services. Here are some that I found based on my search:

1. Employee Assistance Program (EAP): This includes counseling services, customized digital tools, and educational resources aimed at improving work-life balance and overall mental health¹.
2. Psychiatric Care: Carelon covers comprehensive mental health support provided by skilled psychiatrists.
3. Telehealth Providers and Text/Chat Therapy: Carelon also offers coverage for telehealth services and text/chat therapy.
4. Mental Health Benefits for Medi-Cal Members: In collaboration with Partnership, Carelon helps manage mental health benefits for Medi-Cal members with mild to moderate mental health conditions.
5. Mental Health and Substance Use Disorder (MH/SUD) Benefits: These are covered through Carelon Behavioral Health. The patient or their Primary Care Provider (PCP) can call Carelon’s Behavioral Health for these services.
6. Rehab Coverage: Carelon provides insurance benefits that cover treatments and interventions for mental health and substance use disorders².

Remember that the extent of coverage may vary depending on your specific plan. For the most accurate information, it’s recommended to reach out directly to Carelon Healthcare Services.

Which Mental Health Conditions Are Covered by Carelon Healthcare Services Insurance?

Carelon Healthcare Services Insurance provides coverage for a variety of mental health services and conditions. With a focus on delivering whole-person care, they offer connected healthcare solutions for better outcomes and experiences.

Mental Health Conditions Covered:

Carelon covers a wide range of mental health conditions, including but not limited to:

• ADHD (Attention-Deficit/Hyperactivity Disorder): This is a neurodevelopmental disorder often diagnosed in childhood. Individuals with ADHD may struggle with attention, impulsivity, and hyperactivity. Carelon covers comprehensive services, including assessments, psychotherapy, and medication management.
• Anxiety Disorders: This encompasses a range of conditions such as Generalized Anxiety Disorder (GAD), panic disorder, and social anxiety disorder. These disorders are characterized by excessive and persistent worry and fear. Carelon offers coverage for various treatments including psychotherapy and medication management.
• Alzheimer’s: This is a progressive disorder that causes brain cells to waste away (degenerate) and die. Carelon covers a wide range of services, from diagnosis to management of the condition, including behavioral therapies to manage symptoms.
• Anorexia Nervosa: An eating disorder characterized by an intense fear of gaining weight and a distorted body image. Carelon covers treatment modalities such as counseling, therapy, and nutritional management.
• Behavioral Issues: These can range from mild behavioral issues to more severe conditions like conduct disorder. Coverage includes Applied Behavior Analysis, especially for young members.
• Bipolar Disorders: These are mental health conditions characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). Carelon provides coverage for various treatments, including psychotherapy and medication management¹.
• Dementia: A group of conditions characterized by impairment of at least two brain functions, such as memory loss and judgment. Carelon covers services from diagnosis to management, including behavioral therapies to manage symptoms.
• Depression: A mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. Carelon covers treatments like psychotherapy, medication management, and in severe cases, Electroconvulsive Therapy (ECT)¹.
• Mental Health Conditions Requiring Psychotherapy: Carelon covers mental health evaluation and treatment, including individual, group, and family psychotherapy.
• Schizophrenia: A serious mental disorder in which people interpret reality abnormally. Carelon covers comprehensive services for schizophrenia, including psychotherapy, medication management, and supportive services.

The specific conditions covered and the extent of coverage can vary depending on your plan. For the most accurate information, it’s recommended to directly contact Carelon Healthcare Services.

Which Mental Health Treatment Are Covered by Carelon Health Insurance?

In terms of treatment modalities, Carelon covers a broad spectrum of therapeutic interventions including but not limited to:

• Intensive Outpatient Program (IOP)
• Partial Hospitalization Program (PHP)
• Testing and Assessment
• Counseling
• Therapy
• Psychotherapy (Talk Therapy)
• Electroconvulsive Therapy (ECT)
• Transcranial Magnetic Stimulation (TMS)
• Eye Movement Desensitization and Reprocessing (EMDR)
• Spravato
• Medication Management

It’s important to note that the specifics of what is covered can vary based on the individual’s specific health insurance plan and provider network. Therefore, individuals should consult with their healthcare provider and health insurance company for the most accurate information.

How To Find Mental Health Services Near Me in Tennessee That Tale Carelon Insurance

If you’re looking for mental health treatment near you and have Carelon Healthcare Services insurance, Athena Care has multiple locations in Tennessee and accepts Carelon insurance. Whether you’re seeking psychotherapy, counseling services, or behavioral therapy, Athena Care’s centers provide a range of mental health interventions designed to support your journey to wellness.

Athena Care offers a variety of treatment modalities, including cognitive-behavioral therapy (CBT), which can be particularly effective for conditions like depression, anxiety, and PTSD. Their psychiatric treatment services include both medication management and therapy, ensuring a comprehensive approach to mental health care. Recognizing that each individual’s journey is unique, they also provide holistic mental health care, integrating physical, emotional, and spiritual wellness into their treatment plans.

Whether you’re in Nashville, Franklin, Murfreesboro, Hendersonville, Clarksville, Memphis, Knoxville, or any other part of Tennessee, Athena Care strives to make quality mental health care accessible. With a focus on serving local communities, they aim to be the nearest and most convenient option for individuals seeking mental health therapy. So, if you’re searching for “mental health treatment near me” or “mental health therapy in my area,” consider exploring what Athena Care has to offer.

Here you’ll find a list of practitioners organized by city, along with information about their backgrounds and specialties.

About Carelon Healthcare Services Health Insurance

Carelon Healthcare Services is a healthcare organization dedicated to delivering comprehensive care through connected healthcare solutions. They focus on the health of the whole person, providing superior outcomes and experiences for their patients. This holistic approach to healthcare is evident in their nationally recognized disease management programs and their provision of advanced primary care and palliative care services.

In Tennessee, Carelon offers a wide range of services. These include:

1. Advanced Primary Care – This service ensures that high-quality, seamless care is provided when it’s most needed.
2. Behavioral Health Services – Carelon offers evidence-based psychotherapy, counseling services, behavioral therapy, mental health interventions, cognitive-behavioral therapy (CBT), and psychiatric treatment.
3. Medical Benefits Management – This includes post-acute care, ensuring continuity of care after a hospital stay.
4. Home-Based Healthcare Solution – This service ensures that members receive high-quality, affordable post-acute care at home, achieved by collaborating with providers and utilizing a whole-person approach to care.

Carelon works with various insurance plans to make their services accessible to a wide range of individuals. These insurance plans are designed to provide members with the best possible coverage for their healthcare needs, ensuring that they can access the vital services provided by Carelon without worrying about financial burdens.

Does Carelon Healthcare Services Health Insurance Cover Online Therapy?

Yes, Carelon Healthcare Services does provide coverage for telehealth services to participating providers who meet the appropriate criteria. Telehealth is a broad term that encompasses various types of healthcare services provided remotely, including remote or online therapy.

However, the specific coverage of online therapy under Carelon’s health insurance will depend on the individual’s specific plan and the provider’s participation in telehealth services. Therefore, it’s recommended that individuals contact Athena Care to confirm coverage for online therapy.

How Much Do Mental Health Services & Testing Cost Without Carelon Insurance?

The cost of mental health services and testing without insurance can vary greatly depending on the type of service, the provider, and the region in which you live. However, several sources provide some general estimates:

1. Psychiatrist Visits: Without insurance, a person can expect to pay somewhere between $80-$200 on average per session with a psychiatrist. Initial evaluations with a psychiatrist usually run $250 to $300, with follow-up sessions lasting 30 to 60 minutes for $100 to $200 each.
2. Traditional Therapy Sessions: An hour-long traditional therapy session can range from $65 to $250 for those without insurance.
3. Psychological Testing: The cost of psychological testing can vary widely based on the nature of the tests, the time required, and the professional administering the test. While specific costs were not found in the provided context, it’s common for these services to run into hundreds or even thousands of dollars without insurance.

Please note that these are average costs and the actual cost may be higher or lower. Also, there are resources available for free or low-cost treatment for mental health^6,7. It’s advised to explore these options if you don’t have insurance or if the cost of services is a concern.

Moreover, the costs associated with mental health care can be a significant barrier to accessing treatment. It’s important to discuss these concerns with healthcare providers, as they may be able to suggest alternative options or payment plans.

Other In-Network Insurance Providers

Aetna
Ambetter TN
Blue Cross Blue Shield
Evernorth
Medicare
Multiplan
Optum
PHCS
TRICARE
United Healthcare
Vanderbilt