Mental Health & Substance Abuse

About one in five Americans suffers from a diagnosable mental illness, yet only a little more than half receive treatment. (National Institute of Mental Health)

Mental health and substance abuse issues can interfere with people’s overall health, ability to perform their job, and follow a doctor-recommended plan of care. Since chronic medical conditions — such as diabetes, asthma, and heart disease — also have emotional and stress-related triggers, people who suffer from these conditions are more likely to experience mental health and substance abuse issues as well.

Blue Cross & Blue Shield of Rhode Island has partnered with Beacon Health Options to provide our members with help finding the right care:

  • Beacon Health Options 24-hour help line at 1-800-274-2958: Our clinical referral line is monitored 24 hours a day, seven days a week by clinical mental health and substance abuse professionals. You can use this line for help finding a provider, as well as non-emergency situations, and to receive ongoing support and guidance.
  • Beacon Health Options Case Management program at 1-800-274-2958, option 3, then option 1: Independently licensed mental health and substance abuse professionals work with you and coordinate care with your team of providers to get you access to the resources and services you need. They also review any medications you are taking and make sure you understand what they are for and how to take them.
  • Your primary care provider: Although we do not require our members to get a referral for outpatient counseling and medication services, if you or someone you care for may benefit from psychotherapy or another form of mental health and/or substance abuse treatment, the best place to start is with a primary care provider. Discuss symptoms with them and ask for a referral to a provider they respect or maintain a professional relationship with.
  • BCBSRI Customer Service department at 1-800-639-2227: Call for help finding a provider and understanding your benefits.
  • Find a Doctor tool

We cover a comprehensive list of services and benefits to meet the needs of our members with mental health and substance abuse issues. A mental health or substance abuse professional can recommend what treatment plan will work best for you.

  • Outpatient care
    • Individual behavioral health providers (unlimited office visits):
      • Psychiatrist: A medical doctor who specializes in preventing, diagnosing, and treating mental illness. Psychiatrists can prescribe psychiatric medications.
      • Counselor: A licensed, mental health professional with a master’s degree who evaluates and treats common life stressors, and mild to moderate mood disorders, such as a social worker, mental health counselor, or marriage and family therapist. Counselors do not prescribe medications. Refer to your specific benefit information for providers covered under your plan.
      • Psychologist: A licensed, mental health professional with a PhD or a PsyD in clinical psychology who is trained to work with mild or severe psychological issues. Psychologists do not prescribe medications.
    • Intensive outpatient programs*:
      • Typically three days per week, three to four hours per day, for a period of four to six weeks (most are structured so people can continue their normal daily routines)
      • Combination of individual and group therapy (family therapy if appropriate); may include psychiatrist evaluation and medication management
      • Recommended for people who are experiencing emotional and behavioral problems, and would benefit from learning how to manage their symptoms and issues in a structured environment, along with people with similar issues
    • Partial day hospitalization programs*:
      • Typically five days per week, five hours per day
      • Combination of individual and group therapy (family therapy if appropriate); often includes psychiatrist evaluation
      • Recommended for people that require more intensive treatment than traditional outpatient care, are experiencing serious emotional and behavioral problems, are at risk for hospitalization, or as treatment following inpatient hospitalization
  • Inpatient care
    • Inpatient acute hospital care*:
      • Round-the-clock care in a hospital setting; typically lasts a couple of days
      • Daily visits by a team of professionals, including a psychiatrist and group therapy (if appropriate)
      • Recommended to stabilize a crisis and/or severe symptoms
    • Inpatient residential care*:
      • Typically a short-term placement in a residential setting close to a person’s home until they stabilize and can return to the community
      • Combination of group, individual, and family therapy

*Some mental health and substance abuse services require prior authorization.

This information is a summary of benefits provided by the plan. It is not a contract. Other exceptions, reductions and limitations may also apply to your benefits. For details about coverage, please see the subscriber agreement for the plan or contact customer service.