IU Behavioral Health Coverage Change in 2006

The contract between Indiana University Psychiatric Management and Methodist Medical Group (for M Plan members) will terminate effective January 1, 2006. This means all patients, including IU employees and their covered family members, who have M Plan insurance, will no longer have access to IU Department of Psychiatry behavioral health faculty at “in-network” rates.

Some M Plan products have no – or very limited – provision for out-of-network coverage for behavioral health. Therefore, some individuals insured through M Plan may have no coverage if they are seen by Department of Psychiatry faculty. This includes services provided by Psychiatry faculty at Riley Hospital, IU Hospital and other sites.

IU employees who wish to continue to access Department of Psychiatry behavioral health faculty with in-network coverage are urged to choose an Anthem PPO product (IU-PPO Plus or IU PPO $900 Deductible) during open enrollment in November. Employees who continue M Plan coverage can elect to receive services from Department of Psychiatry faculty, but they may be responsible for a significantly larger portion of their charges.

IUPM regrets any hardship this may cause patients and physicians. Despite sincere negotiation, they were unable to obtain a reimbursement rate suitable to cover expenses.

Questions about coverage or ongoing care should be directed to Gerri Voreis, LCSW, Methodist Medical Group, at (317) 865-6926.

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