Mental Health

ANSWER: Continuum of care means getting treatment which directs you to a level of care and a provider appropriate for your treatment needs. As you improve, PBH will progressively move you to a less restrictive level of care that provides effective treatment until you complete treatment.

ANSWER: Referring to the outline of benefits above for mental health, an example of continuum of care would be if you had been hospitalized for a mental disorder and had improved to the point that you no longer required full-time hospitalization, but needed more intensive care than traditional outpatient visits, you could be placed in alternate care such as residential or partial treatment until you had recovered sufficiently to be placed in outpatient treatment.

ANSWER: Yes. PBH has a comprehensive network of providers throughout the state of California. Your EAP counselor will assist you in making certain that your provider is both convenient to where you live or work and is the appropriate provider to treat you for your particular problem.

ANSWER: This would be considered a Non-Network Provider. As indicated on the above charts, no benefits are payable under the Program for mental health or chemical dependency inpatient/alternate care services received from a Non-Network Provider.

ANSWER: Yes. The benefits of the other plan would be taken into consideration in computing the benefits which are payable under this Program.