Mental Health and Substance Abuse

When you enroll in a PPO or Out-of-Area Comprehensive option, you’ll have access to mental health and substance abuse treatment benefits administered through OptumHealth Behavioral Solutions (formerly known as UBH). These benefits cover any outpatient counseling you or your eligible dependents may need beyond the first eight visits covered by the EAP.

The Summary of Health Benefits – Mental Health & Substance Abuse Treatment summarizes the behavioral health benefits available under all the Nortel Networks Medical Plan options.

To receive the maximum level of benefits, you should call OptumHealth first before you go for care, and follow the recommended course of treatment using the OptumHealth network mental health professional to whom you’re referred.

If you receive care from a provider or facility that is not part of the OptumHealth Behavioral Solutions network, your benefit level will be lower than the network level.  These reduced benefits are defined as out-of-network benefits. If you fail to call OptumHealth Behavioral Solutions to pre-certify your care, you may be charged a penalty and your benefits may be reduced. In some cases, if you fail to pre-certify your care, no benefits will be paid. Please refer to Summary of Health Benefits for a description of your network and out-of-network benefits, as well as specific precertification requirements for out-of-network outpatient services.

Benefits will be denied if your care is considered not to be a covered service.

For more information about Mental Health and Substance Abuse coverage, review the Summary of Health Benefits.