Adult Behavioral Health Benefits in Medicaid and the Marketplace

Ken Cannon, Jenna Burton, and MaryBeth Musumeci
Published: Jun 11, 2015

Appendix A: Explicitly Covered Specialty Behavioral Health Services by State

ARIZONA

Appendix Table 1: Arizona Adult Inpatient Behavioral Health Service Coverage
Health Plans		Psychiatric Hospital Visit	23-Hour Observation	Residential Treatment Facility	Adult Group Homes
Medicaid	Medicaid RHBA or TRBHA	X		X	X
Platinum	Health Net CommunityCare HMO Open Access Platinum	X
	Humana Connect Platinum 1000/1500 Plan	X
	Health Net PPO Platinum	X
	Health Choice Essential Platinum	X
Gold	Health Net CommunityCare HMO Open Access Gold	X
	Humana Connect Gold 2500/3500 Plan	X
	Health Net PPO Gold	X
	Aetna Premier 2000 PD	X
	Health Choice Essential Gold	X
	FitRewards 1500	X
	myCigna Health Flex 1250	X		X
	Meritus Healthy Gold	X
	Gold Canyon 575	X
Silver	Health Net CommunityCare HMO Open Access Silver	X
	Humana Connect Silver 4600/6300 Plan	X
	Health Net HAS PPO Silver	X
	Meritus Community Network – Phoenix	X
	EverydayHealth Select (Maricopa) 4000	X
	Health Choice Essential Silver	X
	Aetna Classic 3500 PD	X
	myCigna Health Savings 3400	X		X
	Silver Canyon 1575	X
Bronze	Health Net CommunityCare HAS Open Access Bronze	X
	Health Net PPO Bronze	X
	Aetna Advantage 6350	X
	EverydayHealth Alliance (Maricopa) 6000	X
	Health Choice Essential Bronze	X
	Meritus Premium Saver Bronze	X
	myCigna Health Savings 6100	X		X
	Bronze Canyon	X

Appendix Table 2: Arizona Adult Outpatient Behavioral Health Service Coverage
Health Plans		Case Management	Day Treatment	Partial Hospitalization	Psychosocial Rehabilitation	Intensive Outpatient	Mental Health Rehabilitation
Medicaid	Medicaid RHBA or TRBHA	X	X		X
Platinum	Health Net CommunityCare HMO Open Access Platinum
	Humana Connect Platinum 1000/1500 Plan
	Health Net PPO Platinum
	Health Choice Essential Platinum		X	X
Gold	Health Net CommunityCare HMO Open Access Gold
	Humana Connect Gold 2500/3500 Plan
	Health Net PPO Gold
	Aetna Premier 2000 PD
	Health Choice Essential Gold		X	X
	FitRewards 1500
	myCigna Health Flex 1250					X
	Meritus Healthy Gold
	Gold Canyon 575
Silver	Health Net CommunityCare HMO Open Access Silver
	Humana Connect Silver 4600/6300 Plan
	Health Net HAS PPO Silver
	Meritus Community Network – Phoenix
	EverydayHealth Select (Maricopa) 4000
	Health Choice Essential Silver		X	X
	Aetna Classic 3500 PD
	myCigna Health Savings 3400					X
	Silver Canyon 1575
Bronze	Health Net CommunityCare HAS Open Access Bronze
	Health Net PPO Bronze
	Aetna Advantage 6350
	EverydayHealth Alliance (Maricopa) 6000
	Health Choice Essential Bronze		X	X
	Meritus Premium Saver Bronze
	myCigna Health Savings 6100					X
	Bronze Canyon

Appendix Table 3: Arizona Adult Outpatient Provider Behavioral Health Service Coverage
Health Plans		Psychiatric Services –Evaluation	Psychiatric Services –Testing	Medication Evaluation, Prescription, and Management	Psychological Testing	Individual Testing	Individual Therapy	Group Therapy	Family Therapy
Medicaid	Medicaid RHBA or TRBHA	X	X	X	X	X	X	X	X
Platinum	Health Net CommunityCare HMO Open Access Platinum
	Humana Connect Platinum 1000/1500 Plan
	Health Net PPO Platinum
	Health Choice Essential Platinum	X	X	X
Gold	Health Net CommunityCare HMO Open Access Gold
	Humana Connect Gold 2500/3500 Plan
	Health Net PPO Gold
	Aetna Premier 2000 PD
	Health Choice Essential Gold	X	X	X
	FitRewards 1500
	myCigna Health Flex 1250						X	X
	Meritus Healthy Gold
	Gold Canyon 575			X			X	X
Silver	Health Net CommunityCare HMO Open Access Silver
	Humana Connect Silver 4600/6300 Plan
	Health Net HAS PPO Silver
	Meritus Community Network – Phoenix
	EverydayHealth Select (Maricopa) 4000
	Health Choice Essential Silver	X	X	X
	Aetna Classic 3500 PD
	myCigna Health Savings 3400						X	X
	Silver Canyon 1575			X			X	X
Bronze	Health Net CommunityCare HAS Open Access Bronze
	Health Net PPO Bronze
	Aetna Advantage 6350
	EverydayHealth Alliance (Maricopa) 6000
	Health Choice Essential Bronze	X	X	X
	Meritus Premium Saver Bronze
	myCigna Health Savings 6100						X	X
	Bronze Canyon			X			X	X

Appendix Table 4: Arizona Adult Substance Use Service Coverage
Health Plans		Inpatient Rehab.	Inpatient Detox.	Outpatient Detox.	Residential Rehab.	Methadone Maint.	Suboxone Treatment	Intensive Outpatient	Smoking and Tobacco Use	Partial Hospitalization
Medicaid	Medicaid RHBA or TRBHA		X			X		X	X
Platinum	Health Net CommunityCare HMO Open Access Platinum				X				X
	Humana Connect Platinum 1000/1500 Plan								X
	Health Net PPO Platinum				X				X
	Health Choice Essential Platinum		X	X	X	Medication Management	Medication Management	X	X	X
Gold	Health Net CommunityCare HMO Open Access Gold				X				X
	Humana Connect Gold 2500/3500 Plan								X
	Health Net PPO Gold				X				X
	Aetna Premier 2000 PD				X				X
	Health Choice Essential Gold		X	X	X	Medication Management	Medication Management	X	X	X
	FitRewards 1500				X				X
	myCigna Health Flex 1250				X			X	X
	Meritus Healthy Gold				X				X
	Gold Canyon 575				X	*	*	X	X
Silver	Health Net CommunityCare HMO Open Access Silver				X				X
	Humana Connect Silver 4600/6300 Plan								X
	Health Net HAS PPO Silver				X				X
	Meritus Community Network – Phoenix								X
	EverydayHealth Select (Maricopa) 4000								X
	Health Choice Essential Silver		X	X	X	Medication Management	Medication Management	X	X	X
	Aetna Classic 3500 PD								X
	myCigna Health Savings 3400				X			X	X
	Silver Canyon 1575				X	*	*	X	X
Bronze	Health Net CommunityCare HAS Open Access Bronze				X				X
	Health Net PPO Bronze				X				X
	Aetna Advantage 6350								X
	EverydayHealth Alliance (Maricopa) 6000								X
	Health Choice Essential Bronze		X	X	X	Medication Management	Medication Management	X	X	X
	Meritus Premium Saver Bronze								X
	myCigna Health Savings 6100				X			X	X
	Bronze Canyon				X	*	*	X	X
* University of Arizona Health plans provide pharmaceutical coverage for medication provided during an inpatient residential stay and for medication management during a detoxification.

Colorado

Appendix Table 5: Colorado Adult Inpatient Behavioral Health Service Coverage
Health Plans		Psychiatric Hospital Visit	23-Hour Observation	Residential Treatment Facility	Adult Group Homes
Medicaid	Colorado Medical Assistance Program	X		X
Platinum	Navigate	X
Platinum	Colorado HMOx	X
Gold	Navigate	X
	Denver LocalPlus	X
	CCHP Network	X
	CoOp State Wide Two	X
	DHMP Expanded Network	X		Virtual Residency Therapy
	Pathway x Enhanced	X
	Colorado HMOx	X
	Kaiser Permanente Southern Colorado	X
	Access Health Colorado	X
	Rocky Mountain HMO Statewide Provider Network	X
Silver	Navigate	X
	Denver LocalPlus	X
	CCHP Network	X
	CoOp State Wide One	X
	DHMP Closed Network	X		Virtual Residency Therapy
	Pathway x Enhanced	X
	Colorado HMOx	X
	Kaiser Permanente Southern Colorado	X
	Access Health Colorado	X
	Rocky Mountain HMO Statewide Provider Network	X
Bronze	Navigate	X
	Denver LocalPlus	X
	CCHP Network	X
	CoOp State Wide One	X
	Pathway x Enhanced	X
	Colorado HMOx	X
	Kaiser Permanente Southern Colorado	X
	Access Health Colorado	X
	Rocky Mountain HMO Statewide Provider Network	X

Appendix Table 6: Colorado Adult Outpatient Behavioral Health Service Coverage
Health Plans		Case Management	Day Treatment	Partial Hospitalization	Psychosocial Rehabilitation	Intensive Outpatient	Mental Health Rehabilitation
Medicaid	Colorado Medical Assistance Program	X	X	X	X	X
Platinum	Navigate			X
Platinum	Colorado HMOx
Gold	Navigate			X
	Denver LocalPlus
	CCHP Network
	CoOp State Wide Two	X				X
	DHMP Expanded Network	X		X
	Pathway x Enhanced	X		X		X
	Colorado HMOx
	Kaiser Permanente Southern Colorado			X
	Access Health Colorado	X		X		X
	Rocky Mountain HMO Statewide Provider Network
Silver	Navigate			X
	Denver LocalPlus
	CCHP Network
	CoOp State Wide One	X				X
	DHMP Closed Network	X		X
	Pathway x Enhanced	X		X		X
	Colorado HMOx
	Kaiser Permanente Southern Colorado			X
	Access Health Colorado	X		X		X
	Rocky Mountain HMO Statewide Provider Network
Bronze	Navigate			X
	Denver LocalPlus
	CCHP Network
	CoOp State Wide One	X				X
	Pathway x Enhanced	X		X		X
	Colorado HMOx
	Kaiser Permanente Southern Colorado			X
	Access Health Colorado	X		X		X
	Rocky Mountain HMO Statewide Provider Network

Appendix Table 7: Colorado Adult Outpatient Provider Behavioral Health Service Coverage
Health Plans		Psychiatric Services –Evaluation	Psychiatric Services –Testing	Medication Evaluation, Prescription, & Management	Psychological Testing	Individual Testing	Individual Therapy	Group Therapy	Family Therapy
Medicaid	Colorado Medical Assistance Program	X	X	X	X	X	X	X	X
Platinum	Navigate	X	Psychiatric Treatment		X		X
Platinum	Colorado HMOx						X
Gold	Navigate	X			X		X
	Denver LocalPlus
	CCHP Network
	CoOp State Wide Two	X		X			X	X	X
	DHMP Expanded Network						X	X	X
	Pathway x Enhanced			X	X		X	X	X
	Colorado HMOx						X
	Kaiser Permanente Southern Colorado	X	Psychiatric Treatment		X		X
	Access Health Colorado			X	X		X	X	X
	Rocky Mountain HMO Statewide Provider Network	X					X	X	X
Silver	Navigate	X			X		X
	Denver LocalPlus
	CCHP Network
	CoOp State Wide One	X		X			X	X	X
	DHMP Closed Network						X	X	X
	Pathway x Enhanced			X	X		X	X	X
	Colorado HMOx						X
	Kaiser Permanente Southern Colorado	X	Psychiatric Treatment		X		X
	Access Health Colorado			X	X		X	X	X
	Rocky Mountain HMO Statewide Provider Network	X					X	X	X
Bronze	Navigate	X			X		X
	Denver LocalPlus
	CCHP Network
	CoOp State Wide One	X		X			X	X	X
	Pathway x Enhanced			X	X		X	X	X
	Colorado HMOx						X
	Kaiser Permanente Southern Colorado	X	Psychiatric Treatment		X		X
	Access Health Colorado			X	X		X	X	X
	Rocky Mountain HMO Statewide Provider Network	X					X	X	X

Appendix Table 8: Colorado Adult Substance Use Service Coverage
Health Plans		Inpatient Rehab.	Inpatient Detox.	Outpatient Detox.	Residential Rehab.	Methadone Maint.	Suboxone Treatment	Intensive Outpatient	Smoking and Tobacco Use	Partial Hospitalization
Medicaid	Colorado Medical Assistance Program		X	X		X	X		X
Platinum	Navigate	Monitor Drug Therapy							X
Platinum	Colorado HMOx								X
Gold	Navigate	Monitor Drug Therapy							X
	Denver LocalPlus								X
	CCHP Network								X
	CoOp State Wide Two					Covers Medication Management	Covers Medication Management	X	X
	DHMP Expanded Network		X	X					X
	Pathway x Enhanced		X	X		Covers Medication Management As Part of Medical Detox	Covers Medication Management As Part of Medical Detox		X	X
	Colorado HMOx								X
	Kaiser Permanente Southern Colorado		X	X		Medical Management of Withdrawal Symptoms	Medical Management of Withdrawal Symptoms		X
	Access Health Colorado		X	X		As Part of Medical Detox	As Part of Medical Detox	X	X
	Rocky Mountain HMO Statewide Provider Network
Silver	Navigate	Monitor Drug Therapy							X
	Denver LocalPlus								X
	CCHP Network								X
	CoOp State Wide One					Covers Medication Management	Covers Medication Management	X	X
	DHMP Closed Network		X	X					X
	Pathway x Enhanced		X	X		Covers Medication Management As Part of Medical Detox	Covers Medication Management As Part of Medical Detox		X	X
	Colorado HMOx								X
	Kaiser Permanente Southern Colorado		X	X		Medical Management of Withdrawal Symptoms	Medical Management of Withdrawal Symptoms		X
	Access Health Colorado		X	X		As Part of Medical Detox	As Part of Medical Detox	X	X
	Rocky Mountain HMO Statewide Provider Network
Bronze	Navigate	Monitor Drug Therapy							X
	Denver LocalPlus								X
	CCHP Network								X
	CoOp State Wide One					Covers Medication Management	Covers Medication Management	X	X
	Pathway x Enhanced		X	X		Covers Medication Management As Part of Medical Detox	Covers Medication Management As Part of Medical Detox		X	X
	Colorado HMOx								X
	Kaiser Permanente Southern Colorado		X	X		Medical Management of Withdrawal Symptoms	Medical Management of Withdrawal Symptoms		X
	Access Health Colorado		X	X		As Part of Medical Detox	As Part of Medical Detox	X	X
	Rocky Mountain HMO Statewide Provider Network

CONNECTICUT

Appendix Table 9: Connecticut Adult Inpatient Behavioral Health Service Coverage
Health Plans		Psychiatric Hospital Visit	23-Hour Observation	Residential Treatment Facility	Adult Group Homes
Medicaid	Husky A	X	X	X	X
	Husky C	X	X	X	X
	Husky D	X	X	X	X
Gold	Anthem Gold Direct Access (cddm)	X		X
	Anthem Gold Direct Access Standard (cddk)	X		X
	ConnectiCare Standard Gold POS	X		X
	HCT Healthy Partner Preferred	X		X
Silver	Anthem Silver Direct Access (cdne)	X		X
	Anthem Silver Direct Access Standard (cboa)	X		X
	ConnectiCare Standard POS	X		X
	HCT Healthy Partner Max 1	X		X
Bronze	Anthem Bronze Direct Access (cdad)	X		X
	Anthem Bronze Direct Access Standard (cdcm)	X		X
	Anthem Bronze Direct Access w/ HSA	X		X
	ConnectiCare Bronze POS 10/20	X		X
	ConnectiCare Bronze POS 20/30	X		X
	ConnectiCare POS	X		X
	HCT Healthy Partner Essential	X		X
	HCT Healthy Partner Basic Plus	X		X

Appendix Table 10: Connecticut Adult Outpatient Behavioral Health Service Coverage
Health Plans		Case Management	Day Treatment*	Partial Hospitalization	Psychosocial Rehabilitation	Intensive Outpatient	Mental Health Rehabilitation**
Medicaid	Husky A	X	X	X	X	X
	Husky C	X	X	X	X	X
	Husky D	X	X	X	X	X
Gold	Anthem Gold Direct Access (cddm)	X***		X		X
	Anthem Gold Direct Access Standard( cddk)	X***		X		X
	ConnectiCare Standard Gold POS			X		X
	HCT Healthy Partner Preferred			X		X
Silver	Anthem Silver Direct Access (cdne)	X***		X		X
	Anthem Silver Direct Access Standard (cboa)	X***		X		X
	ConnectiCare Standard POS			X		X
	HCT Healthy Partner Max 1					X
Bronze	Anthem Bronze Direct Access (cdad)	X***		X		X	X
	Anthem Bronze Direct Access Standard (cdcm)	X***		X		X	X
	Anthem Bronze Direct Access w/ HSA	X***		X		X	X
	ConnectiCare Bronze POS 10/20			X		X	X
	ConnectiCare Bronze POS 20/30			X		X	X
	ConnectiCare POS			X		X	X
	HCT Healthy Partner Essential					X	X
	HCT Healthy Partner Basic Plus					X	X
* Community Behavioral Health Program. Limited to those in Private Nonprofit Mental Institutions (PNMIs). * Plan may also extend Covered Services beyond the Benefit Maximums of this Plan.

Appendix Table 11: Connecticut Adult Outpatient Provider Behavioral Health Service Coverage
Health Plans		Psychiatric Services –Evaluation	Psychiatric Services –Testing	Medication Evaluation, Prescription, & Management	Psychological Testing	Individual Testing	Individual Therapy	Group Therapy	Family Therapy
Medicaid	Husky A	X	X	X	X	X	X	X	X
	Husky C	X	X	X	X	X	X	X	X
	Husky D	X	X	X	X	X	X	X	X
Gold	Anthem Gold Direct Access (cddm)
	Anthem Gold Direct Access Standard (cddk)
	ConnectiCare Standard Gold POS
	HCT Healthy Partner Preferred
Silver	Anthem Silver Direct Access (cdne)
	Anthem Silver Direct Access Standard (cboa)
	ConnectiCare Standard POS
	HCT Healthy Partner Max 1
Bronze	Anthem Bronze Direct Access (cdad)
	Anthem Bronze Direct Access Standard (cdcm)
	Anthem Bronze Direct Access w/ HSA
	ConnectiCare Bronze POS 10/20
	ConnectiCare Bronze POS 20/30
	ConnectiCare POS
	HCT Healthy Partner Essential

Appendix Table 12: Connecticut Adult Substance Use Service Coverage
Health Plans		Inpatient Rehab.	Inpatient Detox.	Outpatient Detox.	Residential Rehab.	Methadone Maint.	Suboxone Treatment	Intensive Outpatient	Smoking and Tobacco Use	Partial Hospitalization
Medicaid	Husky A		X	X	X	X	X	X	X
	Husky C		X	X	X	X	X	X	X
	Husky D		X	X	X	X	X	X	X
Gold	Anthem Gold Direct Access (cddm)	X						X	X	X
	Anthem Gold Direct Access Standard (cddk)	X						X	X	X
	ConnectiCare Standard Gold POS	X			X			X	X	X
	HCT Healthy Partner Preferred	X	`					X	*
Silver	Anthem Silver Direct Access (cdne)	X						X	X	X
	Anthem Silver Direct Access Standard (cboa)	X						X	X	X
	ConnectiCare Standard POS	X			X			X	X	X
	HCT Healthy Partner Max 1	X						X	*
Bronze	Anthem Bronze Direct Access (cdad)	X						X	X	X
	Anthem Bronze Direct Access Standard (cdcm)	X						X	X	X
	Anthem Bronze Direct Access w/ HSA	X						X	X	X
	ConnectiCare Bronze POS 10/20	X			X			X	X	X
	ConnectiCare Bronze POS 20/30	X			X			X	X	X
	ConnectiCare POS	X			X			X	X	X
	HCT Healthy Partner Essential	X						X	*
	HCT Healthy Partner Basic Plus	X						X	*
* Smoking cessation is covered if the beneficiary meets program criteria.

MICHIGAN

Appendix Table 13: Michigan Adult Inpatient Behavioral Health Service Coverage
Health Plans		Psychiatric Hospital Visit	23-Hour Observation	Residential Treatment Facility	Adult Group Homes
Medicaid	Medicaid Program (fee-for-service Medicaid)
	Medicaid Health Plans (managed care Medicaid)
	Prepaid Inpatient Health Plans (specialty managed behavioral health care organizations)	X	X
Platinum	HAP Personal Alliance 500	X	X
	Humana Connect Platinum 100/1500 Plan	X
	McLaren Rewards Platinum	X
Gold	Blue Cross Gold, a Multi-State Plan	X
	Consumers Mutual Premier – No Deductible	X
	HAP Personal Alliance 1500 PPO	X	X	X
	Humana Connect Gold 2500/3500 Plan	X
	McLaren Rewards Gold	X
	Meridian Choice: Your Connection to Bronson Healthcare	X
	Molina Marketplace Gold Plan	X		X
	MyPriority Access HSA Gold 1250	X
	Total HMO Standard	X
Silver	Blue Cross Preferred Silver	X		X
	Consumers Mutual Choice – Low Deductible	X
	HAP Personal Alliance 3000	X	X	X
	Humana Connect Silver 4600/6300 Plan	X
	McLaren Rewards Silver	X
	Meridian Choice: Your Connection to Bronson Healthcare	X
	Molina Silver 150 Plan	X		X
	MyPriority MyHealth Silver 2000	X
	Totally You	X
Bronze	Blue Cross Select Bronze	X		X
	Consumers Mutual Basic – High Deductible	X
	HAP Personal Alliance 5000	X	X
	Humana Connect Bronze 6300/6300 Plan	X
	Meridian Choice: Your Connection to Bronson Healthcare	X
	Molina Marketplace Bronze Plan	X		X
	MyPriority HSA Bronze 6000	X

Appendix Table 14: Michigan Adult Outpatient Behavioral Health Service Coverage
Health Plans		Case Management	Day Treatment	Partial Hospitalization	Psychosocial Rehabilitation	Intensive Outpatient	Mental Health Rehabilitation
Medicaid	Medicaid Program (fee-for-service Medicaid)*			Not Required
	Medicaid Health Plans (managed care Medicaid)
	Prepaid Inpatient Health Plans (specialty managed behavioral health care organizations)	X	X**	X	Yes, as Clubhouse
Platinum	HAP Personal Alliance 500		X			X
	Humana Connect Platinum 100/1500 Plan	X
	McLaren Rewards Platinum			X
Gold	Blue Cross Gold, a Multi-State Plan	X		X
	Consumers Mutual Premier – No Deductible			X		X
	HAP Personal Alliance 1500 PPO		X			X
	Humana Connect Gold 2500/3500 Plan	X
	McLaren Rewards Gold			X
	Meridian Choice: Your Connection to Bronson Healthcare			X		X
	Molina Marketplace Gold Plan	X				X
	MyPriority Access HSA Gold 1250			X		X
	Total HMO Standard			X		X
Silver	Blue Cross Preferred Silver	X		X		X
	Consumers Mutual Choice – Low Deductible			X		X
	HAP Personal Alliance 3000		X			X
	Humana Connect Silver 4600/6300 Plan	X
	McLaren Rewards Silver			X
	Meridian Choice: Your Connection to Bronson Healthcare			X		X
	Molina Silver 150 Plan	X				X
	MyPriority MyHealth Silver 2000			X		X
	Totally You			X		X
Bronze	Blue Cross Select Bronze	X		X		X
	Consumers Mutual Basic – High Deductible			X		X
	HAP Personal Alliance 5000		X			X
	Humana Connect Bronze 6300/6300 Plan	X
	Meridian Choice: Your Connection to Bronson Healthcare			X		X
	Molina Marketplace Bronze Plan	X				X
	MyPriority HSA Bronze 6000			X		X
* MHPs must provide up to 20 visits-per-year and may be provided through contracts with PIHPs/CMSHPs. ** Medicaid Provider Manual uses the term “day program.”

Appendix Table 15: Michigan Adult Outpatient Provider Behavioral Health Service Coverage
Health Plans		Psychiatric Services –Evaluation	Psychiatric Services –Testing	Medication Evaluation, Prescription, & Management	Psychological Testing	Individual Testing	Individual Therapy	Group Therapy	Family Therapy
Medicaid	Medicaid Program (fee-for-service Medicaid)
	Medicaid Health Plans (managed care Medicaid)
	Prepaid Inpatient Health Plans (specialty managed behavioral health care organizations)	X	X	X	X		X	X
Platinum	HAP Personal Alliance 500						X	X
	Humana Connect Platinum 100/1500 Plan					X	X
	McLaren Rewards Platinum	X					X
Gold	Blue Cross Gold, a Multi-State Plan				X		X	X	X
	Consumers Mutual Premier – No Deductible	X	Diagnostic Coverage		Diagnostic Coverage		X	X
	HAP Personal Alliance 1500 PPO	X	Diagnostic Coverage	X	Diagnostic Coverage		X	X
	Humana Connect Gold 2500/3500 Plan					X	X
	McLaren Rewards Gold	X					X
	Meridian Choice: Your Connection to Bronson Healthcare		Diagnostic Coverage		Diagnostic Coverage		X	X
	Molina Marketplace Gold Plan			X	X		X	X
	MyPriority Access HSA Gold 1250		Diagnostic Coverage	X	Diagnostic Coverage		X	X
	Total HMO Standard	X					X	X
Silver	Blue Cross Preferred Silver	X					X	X	X
	Consumers Mutual Choice – Low Deductible	X	Diagnostic Coverage		Diagnostic Coverage		X	X
	HAP Personal Alliance 3000	X	Diagnostic Coverage	X	Diagnostic Coverage		X	X
	Humana Connect Silver 4600/6300 Plan					X	X
	McLaren Rewards Silver	X					X
	Meridian Choice: Your Connection to Bronson Healthcare		Diagnostic Coverage		Diagnostic Coverage		X	X
	Molina Silver 150 Plan			X	X		X	X
	MyPriority MyHealth Silver 2000		Diagnostic Coverage	X	Diagnostic Coverage		X	X
	Totally You	X					X	X
Bronze	Blue Cross Select Bronze	X					X	X	X
	Consumers Mutual Basic – High Deductible	X	Diagnostic Coverage		Diagnostic Coverage		X	X
	HAP Personal Alliance 5000						X	X
	Humana Connect Bronze 6300/6300 Plan					X	X
	Meridian Choice: Your Connection to Bronson Healthcare		Diagnostic Coverage		Diagnostic Coverage		X	X
	Molina Marketplace Bronze Plan			X	X		X	X
	MyPriority HSA Bronze 6000		Diagnostic Coverage	X	Diagnostic Coverage		X	X

Appendix Table 16: Michigan Adult Substance Use Service Coverage
Health Plans		Inpatient Rehab.	Inpatient Detox.	Outpatient Detox.	Residential Rehab.	Methadone Maintenance	Suboxone Treatment	Intensive Outpatient	Smoking and Tobacco Use	Partial Hospitalization
Medicaid	Medicaid Program (fee-for-service Medicaid)		Not Required*	Not Required	Not Required	Not Required	Not Required	Not Required	X
	Medicaid Health Plans (managed care Medicaid)		X
	Prepaid Inpatient Health Plans (specialty managed behavioral health care organizations)		X	X	X	X	X	X
Platinum	HAP Personal Alliance 500		X	X					X
	Humana Connect Platinum 100/1500 Plan				X				X
	McLaren Rewards Platinum				X				X
Gold	Blue Cross Gold, a Multi-State Plan			X	X	Pays for Drugs Used in Facility	Pays for Drugs Used in Facility		X
	Consumers Mutual Premier – No Deductible	Intensive Inpatient	X	X				X	X	X
	HAP Personal Alliance 1500 PPO		X	X	X				X	X
	Humana Connect Gold 2500/3500 Plan				X				X
	McLaren Rewards Gold				X				X
	Meridian Choice: Your Connection to Bronson Healthcare	Intensive Inpatient	X	X	X				X	X
	Molina Marketplace Gold Plan		X	X		Prescription Drugs for Withdrawal	Prescription Drugs for Withdrawal	X	X
	MyPriority Access HSA Gold 1250	Intensive Inpatient	X	X		Pays for Drugs Used in Facility	Pays for Drugs Used in Facility	X	X	X
	Total HMO Standard	Intensive Inpatient	X	X	X			X	X	X
Silver	Blue Cross Preferred Silver		X	X	X			X	X	X
	Consumers Mutual Choice – Low Deductible	Intensive Inpatient	X	X				X	X	X
	HAP Personal Alliance 3000		X	X	X				X	X
	Humana Connect Silver 4600/6300 Plan				X				X
	McLaren Rewards Silver				X				X
	Meridian Choice: Your Connection to Bronson Healthcare	Intensive Inpatient	X	X	X				X	X
	Molina Silver 150 Plan		X	X		Prescription Drugs for Withdrawal	Prescription Drugs for Withdrawal	X	X
	MyPriority MyHealth Silver 2000	Intensive Inpatient	X	X		Pays for Drugs Used in Facility	Pays for Drugs Used in Facility	X	X	X
	Totally You	Intensive Inpatient	X	X	X			X	X	X
Bronze	Blue Cross Select Bronze		X	X	X			X	X	X
	Consumers Mutual Basic – High Deductible	Intensive Inpatient	X	X				X	X	X
	HAP Personal Alliance 5000		X	X					X
	Humana Connect Bronze 6300/6300 Plan				X				X
	Meridian Choice: Your Connection to Bronson Healthcare	Intensive Inpatient	X	X	X				X	X
	Molina Marketplace Bronze Plan		X	X		Prescription Drugs for Withdrawal	Prescription Drugs for Withdrawal	X	X
	MyPriority HSA Bronze 6000	Intensive Inpatient	X	X		Pays for Drugs Used in Facility	Pays for Drugs Used in Facility	X	X	X
* Only required if hospitalized for medical complications due to substance abuse.

Methodology Appendix B: Additional Information on Study States’ Medicaid Programs

Adult Behavioral Health Benefits in Medicaid and the Marketplace

Appendix A: Explicitly Covered Specialty Behavioral Health Services by State

ARIZONA

Colorado

CONNECTICUT

MICHIGAN

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