Accessing Mental Health and Substance Abuse Benefits
If you participate in any of Stanford's medical benefits with the exception of the Catastrophic medical benefit you are automatically covered for mental health and substance abuse benefits administered by Value Behavioral Health (VBH).
To maximize your benefits, you must receive preauthorization from VBH by calling 1-800982-8162. If you know which provider you wish to see, ask the VBH representative if that person is in the VBH network. If the person is not in the network, or if you have no provider preference, the VBH representative will provide a referral for you.
Preapproved Network Services
Your benefits for mental health or substance abuse benefits services, when using a network provider preapproved by VBH, are:
- You pay no deductible
- Mental Health benefits are paid at:
- 80% for visits 1-10
- 60% for visits 11-20
- 40% for visits 21-50 (no benefit paid after 50 visits)
- Substance Abuse benefits are paid at:
- 100% for approved outpatient services if the program is completed
- 80% for approved inpatient services if the program is completed
Non-Network (or Not Preapproved Network) Out-Patient Services
The non-preapproved network, or non-network out-patient benefits for Stanford's Mental Health and Substance services have been changed to a 20-visit per year maximum from the former $1,000 per year limit. These changes are retroactive to January 1, 1998.
The changes apply to out-patient mental health and substance abuse services provided through VBH that are either:
- Without VBH preapproval by an in-network provider, or
- By an out-of-network provider.
The following table summarizes the changes: