FCHP - Behavioral health benefits [PDF]

Behavioral health benefits. Fallon Health partners with Beacon Health Strategies LLC (Beacon), a Beacon Health Options c

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Skip to Main Content | FCHP Homepage | Accessibility Statement

1-800-868-5200 (TRS 711) Mon., Tue., Thu., Fri.: 8 a.m. to 6 p.m. Wed: 10 a.m. to 6 p.m. For new Fallon members How your coverage works Costs Behavioral health benefits Vision care and eyewear benefits What to do if you receive a bill How to read your Health Benefits Statement Authorization requirements and policies Clinical guidelines Find doctors and facilities myFallon Pharmacy and prescription drugs Health and wellness Forms library News and announcements Resources Frequently asked questions Accessibility statement

Behavioral health benefits Fallon Health partners with Beacon Health Strategies LLC (Beacon), a Beacon Health Options company, to provide behavioral health services. Behavioral health services include mental health and substance abuse care. Beacon is available 24 hours a day, seven days a week at 1-888-421-8861. You don’t need a referral from your primary care provider (PCP) to see a therapist. We encourage you to talk with your PCP about any behavioral health concerns you have. For emergency or urgently needed care, call Beacon immediately. If you or a family member are experiencing a mental health or substance use disorder crisis, you can also contact the Emergency Services Program/Mobile Crisis Intervention (ESP/MCI). ESP/MCI is available 24 hours a day, 7 days a week, 365 days a year. Go to the Emergency Services Program/Mobile Crisis Intervention website To find a provider for routine appointments, call Beacon during regular business hours. They’ll give you names and phone numbers of behavioral health specialists in your area, and you may schedule your own appointment. If you have any problems getting an appointment within 10 business days, call Beacon and they will help get you an appointment. For outpatient counseling, you do not need to get prior approval. After you have seen your behavioral health specialist for eight mental health visits in one benefit year, your provider must submit an authorization for additional visits.* Some outpatient services require prior approval. If you have questions, call Fallon Health at the number on the back of your ID card, or Beacon at 1888-421-8861.

Beacon's website for Fallon members Search behavioral health providers, download forms, find resources and more. 1. Visit beaconhealthoptions.com/members/login/ 2. Select "Massachusetts" as your state. 3. Select "Fallon Health" as your health plan.

Find a behavioral health provider 1. Go to Beacon's provider search tool. 2. Fill in search criteria. 3. To choose your plan type: look at the right side of your health plan ID card to find your plan name. If your plan name is: MassHealth Choose "MassHealth” as your plan type.

Fallon Senior Plan HMO, HMO-POS, NaviCare All other or PPO plan names Choose “Medicare” as your plan type. Choose “NaviCare Dual” as your plan Choose “Commercial” as your plan type. type.

4. Check with the provider you are considering to make sure he or she accepts your specific Fallon Health insurance plan or product.

Questions? If you have questions about your benefits, call Fallon Customer Service at 1-800-868-5200. If you have questions about a claim for behavioral health, call Beacon at 1-888-421-8861. * Fallon Senior Plan and NaviCare members do not require additional referrals. MassHealth members require authorization after 12 visits.

© 2018, Fallon Health. All rights reserved. | Website privacy policy | HIPAA Notice of Privacy Practices One Chestnut Place, 10 Chestnut Street, Worcester, MA 01608 1-800-868-5200 (TRS 711), Mon., Tue., Thu., Fri.: 8 a.m. to 6 p.m. Wed: 10 a.m. to 6 p.m. Notice of non-discrimination (pdf) For information in other languages: English

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