HealthPartners

Mental health care is as important as physical health care, yet navigating insurance coverage can sometimes feel overwhelming, especially when you or a loved one is experiencing a behavioral health crisis. HealthPartners, a Minnesota-based insurance provider, offers comprehensive coverage for mental health and substance use disorder treatment as part of its commitment to whole-person care.

Nearly one in five Americans experiences a mental health condition each year, making access to appropriate care essential. If you're covered by HealthPartners insurance and seeking mental health or substance use disorder treatment, this guide will help you understand your benefits, navigate the approval process, and find the care you need.

What Sets HealthPartners Apart in Mental Health Coverage

HealthPartners takes an integrated approach to mental health care, recognizing the connection between physical and mental wellbeing. As both a care provider and insurance company, HealthPartners has a unique perspective on the importance of accessible mental health services. This dual role allows them to develop insurance plans that better meet the needs of those seeking behavioral health treatment.

The organization has made mental health a main focus, developing a wide range of services and programs designed to meet diverse needs. With over 60 mental health clinics throughout the Twin Cities and western Wisconsin, HealthPartners offers extensive geographical coverage for in-network care.

Mental Health Services Covered by HealthPartners

HealthPartners insurance plans cover a broad spectrum of mental health and substance use disorder services as part of the essential health benefits required by the Affordable Care Act.

Common Mental Health Services Covered

• Outpatient therapy and counseling (individual, group, and family therapy)

• Psychiatry services (evaluation, diagnosis, and medication management)

• Psychological testing and assessment services

• Inpatient mental health treatment for acute conditions

• Residential treatment programs (including Melrose Center for eating disorders)

• Partial hospitalization programs (such as DayBridge at Regions Hospital)

• Substance use disorder treatment (assessment, outpatient, intensive outpatient)

• Crisis intervention services and emergency mental health care

• Specialized treatments like transcranial magnetic stimulation (TMS)

HealthPartners' network includes psychiatrists, psychologists, marriage and family therapists, clinical social workers, and primary care physicians with mental health expertise. This diverse network ensures you can find the appropriate provider for your specific needs. Many HealthPartners primary care clinics can help with common conditions like anxiety and depression, while specialists are available for more complex conditions.

How Insurance Verification Works with HealthPartners

Understanding how your insurance works is crucial before beginning mental health treatment to avoid unexpected costs and ensure you receive maximum benefits.

The verification process typically begins by contacting HealthPartners Member Services using the number on your insurance card. You'll want to ask about your specific mental health coverage, deductibles, copayments or coinsurance, any visit limitations, in-network providers, and authorization requirements.

HealthPartners offers specialized behavioral health navigators at 888-638-8787 who can help you understand your benefits and find appropriate in-network providers. These navigators provide compassionate assistance and can answer specific questions about your mental and behavioral health benefits.

Some services, particularly higher levels of care like inpatient treatment or partial hospitalization programs, may require prior authorization. The authorization process involves your provider submitting clinical information to HealthPartners for review, with decisions based on medical necessity criteria and your specific plan's coverage policies.

Coverage Limitations and Out-of-Pocket Costs

While HealthPartners provides substantial mental health coverage, understanding potential limitations and costs will help you better plan for treatment.

Network restrictions typically apply, with out-of-network providers resulting in higher costs unless your plan includes out-of-network benefits. Services must be deemed medically necessary to be covered, which may limit coverage for certain therapy types. Some plans may also limit the number of therapy sessions or days of inpatient treatment covered per year.

Your out-of-pocket costs for mental health services with HealthPartners depend on your specific plan and may include a deductible (the amount you pay before insurance coverage begins), copayments (fixed amounts per visit), coinsurance (a percentage of costs), and your plan's out-of-pocket maximum (the most you'll pay before insurance covers 100%).

Navigating the Insurance Approval Process

Getting mental health treatment approved by your insurance can sometimes feel complex, but understanding the process helps reduce stress during an already challenging time.

The approval process typically begins with an initial assessment to determine diagnosis and appropriate treatment, followed by treatment plan development. Your provider will verify your insurance benefits and submit necessary documentation, including authorization requests for services requiring prior approval. HealthPartners then reviews the request and makes a coverage decision, with periodic reviews potentially required for continuing treatment.

For a smoother approval process, work closely with your provider who has experience navigating insurance requirements, keep detailed records of all communications with HealthPartners, understand your appeals rights if coverage is denied, and utilize the behavioral health navigators for assistance with understanding the process.

Finding Facilities That Accept HealthPartners

HealthPartners works with numerous mental health and substance use disorder treatment facilities throughout Minnesota and western Wisconsin.

You can find in-network providers through the online provider directory on HealthPartners' website, by calling Member Services, or by speaking with a behavioral health navigator. Using in-network facilities offers several advantages, including lower out-of-pocket costs, streamlined billing processes, coordinated care through HealthPartners' integrated approach, and smoother authorization processes since these providers understand HealthPartners' requirements.

Recent Developments in HealthPartners Mental Health Coverage

HealthPartners has continued to enhance its mental health offerings to meet growing demand and changing needs. The organization has broadened its services, developing specialized programs for substance use disorders, eating disorders, and veteran care, while also increasing telehealth options to make mental health care more accessible.

The organization offers two specialized substance use disorder treatment programs: Programs for Change and Hutchinson Hospital Chemical Dependency Program. These provide comprehensive care including assessment, outpatient treatment, and intensive outpatient programming.

HealthPartners has also made reducing mental health stigma a priority through initiatives like the Make It OK campaign, which provides tools and resources for talking about mental health issues respectfully. This commitment to destigmatization helps encourage people to seek the care they need without shame or hesitation.

Determining if Your Specific Plan Covers Needed Treatment

Each HealthPartners insurance plan has different coverage levels and requirements. Understanding your specific plan is essential to maximizing your benefits.

To verify your coverage, review your plan documents (the Summary of Benefits and Coverage outlines mental health benefits), use online member resources through your HealthPartners account, and call Member Services for the most accurate information using the number on your insurance card.

When speaking with representatives, ask about what mental health services are covered under your plan, your cost-sharing responsibilities for different levels of care, whether you need referrals to see specialists, if there are annual limits on services, which providers are in your network, and the process for emergency mental health services.

Accessing HealthPartners Mental Health Services

Many people begin by consulting their primary care doctor, who can provide initial assessment and referrals. HealthPartners allows members to schedule directly with mental health providers without a referral in most cases. For crisis situations, emergency mental health services are available at facilities like Regions Hospital, which specializes in behavioral health.

When contacting providers, have your insurance card ready, along with a brief description of your symptoms or concerns, information about any previous mental health treatment, and questions about the provider's approach and experience.

Finding the Right Treatment Facility

Choosing the right treatment facility is a crucial step in your recovery journey. Consider the level of care needed (outpatient, intensive outpatient, partial hospitalization, or inpatient), the facility's specialization in treating your specific condition, its location relative to your home and support systems, the treatment approaches used, insurance acceptance, and appropriate accreditation.

When evaluating potential facilities, ask about their specialization in treating your condition, the levels of care offered, their treatment philosophy, how they handle insurance verification and billing with HealthPartners, typical treatment length, family involvement, and aftercare support.

Taking the Next Step Toward Mental Health Care

Seeking help for mental health or substance use concerns is a courageous step toward healing and recovery. With HealthPartners insurance, you have access to a wide range of treatment options and providers dedicated to supporting your journey to better mental health.

Remember that navigating insurance can be challenging, but you don't have to do it alone. HealthPartners offers resources to help you understand your coverage and find appropriate care. By using the information in this guide and reaching out for assistance when needed, you can make informed decisions about your mental health treatment.

Ready to find mental health or substance use disorder treatment covered by HealthPartners? Browse our treatment directory to find facilities in your area that accept HealthPartners insurance and offer the specialized care you need.

References

[1] "Mental health treatment services | HealthPartners & Park Nicollet" https://www.healthpartners.com/care/everyday/mental-health/

[2] "Mental and behavioral health | HealthPartners & Park Nicollet" https://www.healthpartners.com/care/specialty/mental-behavioral-health/

[3] "Insurance plan Member Services and support | HealthPartners" https://www.healthpartners.com/insurance/members/support/