Eligibility
The delivery of mental health and substance abuse benefits, including eligibility for coverage, will depend on the PG&E medical plan in which you are enrolled. For details, see the Health Care Participation section.
If you're enrolled in a medical plan administered by Anthem Blue Cross (except for the HSA Medical Plan)
The Mental Health and Substance Abuse Program, administered by ValueOptions, provides these services. Coverage begins on the same date as your medical plan coverage.
If you're enrolled in the HSA Medical Plan
All mental health benefits are provided directly by Anthem Blue Cross. See separate HSA booklet for details.
If you're enrolled in any HMO other than Kaiser Permanente Senior Advantage or Health Net Seniority Plus
All mental health benefits are provided directly by your HMO (benefits vary by plan; call the HMO's member services number for details).
Substance Abuse benefits are provided through the Program administered by ValueOptions (VO). All inpatient and alternate levels of care for substance abuse treatment through the VO Program must be pre-approved by VO; otherwise, no coverage is provided. Coverage begins on the same date as your medical plan coverage.
If you're enrolled in Kaiser Permanente EPO or Kaiser Permanente Senior Advantage
All mental health, including structured outpatient or partial hospitalization, and outpatient substance abuse care treatment is provided directly through Kaiser Permanente. Coverage begins on the same date as your medical plan coverage.
For substance abuse treatment, only outpatient detoxification services and structured day treatment outpatient services for substance abuse treatment are provided by Kaiser Permanente. Inpatient or Residential Alcohol and Drug treatment is provided by ValueOptions and must be pre-approved by VO; otherwise, no coverage is provided. Coverage begins on the same date as your medical plan coverage.
If you're enrolled in Health Net Seniority Plus
All mental health benefits are provided directly by Health Net Seniority Plus (call the Health Net Seniority Plus' member services number for details).
Substance Abuse benefits are provided either directly by Health Net Seniority Plus or through the Program administered by ValueOptions (VO). All inpatient and alternate levels of care for substance abuse treatment through the VO Program must be pre-approved by VO; otherwise, no coverage is provided. Coverage begins on the same date as your medical plan coverage.