Mental Health & Substance Abuse

90/10 Coinsurance Plan

Find solutions to personal problems so that you and your family can lead healthy, active and productive lives. Individual & Family Counseling, Mental & Nervous Conditions, and Substance Abuse Benefits are administered by Mental Health Consultants (MHC).

When participants visit providers who are in-network with Mental Health Consultants, the Fund pays 90% of the total Mental Health allowance leaving the participant with a coinsurance of only 10%. Participants are responsible for coinsurance until they have met their out-of-pocket maximum (see graphic below). Once an individual or family has reached their OOP Max, the Fund will pay 100% for all further In-Network claims for the duration of the Plan Year (May 1 through April 30).

Covered Behavioral Health Benefits include:

  • Psychiatrists & Psychologists
  • Social Workers & Licensed Counselors
  • Substance Abuse
  • In-Patient & Out-Patient Treatment Facilities
  • Individual & Family Counseling
  • Mental & Nervous Conditions

*The $2,000 annual out-of-pocket maximum is a combined total between medical and mental health claims.

All mental health services are administered through Mental Health Consultants (MHC). Call or visit their website for more information or to find a participating provider.

Mental Health Consultants, Inc., 1501 Lower State Road, Building D, Suite 200, North Wales, PA 19454

(800) 255-3081 or locally at (215) 343-8987

Helpful Benefit Coverage Info

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Mental Health FAQs

What does Individual Counseling cost?

If you visit a Psychologist, Psychiatrist, or Counselor from Mental Health Consultants (MHC) Network of Participating Providers, you will be responsible for 10% of the charges. However, if you visit a Non-Participating Provider, you will be responsible for all charges until you reach your annual $10,000 (Individual) or $20,000 (Family) Deductible.

I want to go out of state for in-patient treatment. What are my options?

Mental Health Consultants (MHC) offers an extensive list of Participating Behavioral Health Providers, and Treatment Facilities for Mental Health & Substance Abuse. If you are considering obtaining any type of Behavioral Health Services, including in-patient facility stays, it is imperative you contact MHC at 1-800-255-3081 to discuss which facilities and locations are best for your course of treatment. Failing to choose an in-network facility will result in a $10,000 (Individual) or $20,000 (Family) Deductible, in addition to a 90/10% Coinsurance.

What is the out-of-network deductible?

Any out of network treatment / counseling has a $10,000 deductible per individual or $20,000 deductible per family before payment is made. If you have chosen a provider who is out of network, please contact Mental Health Consultants (MHC) for more assistance