Benefits Overview

We can help you with:

  • Anxiety
  • Attention Deficit Disorder (ADD)
  • Bi-Polar Disorder
  • Depression
  • Eating Disorders (such as anorexia or bulimia)
  • Obsessive-Compulsive Disorders (OCD)
  • Schizophrenia
  • Substance Abuse (such as drug and/or alcohol problems)
  • Other mental or behavioral health conditions

Title XIX/XXI Adult Members who have an SMI Determination and are enrolled with Cenpatico Integrated Care are eligible for Physical Health Care Services. Click Here to view the Physical Health Benefits. For Behavioral Health Service/Benefit Descriptions Click Here

Available Behavioral Health Services

Behavioral health services help people think, feel, and act in healthy ways. There are services for mental health problems and there are services for substance abuse. You can get services based on three things:

  • Your need,
  • Your insurance coverage, and
  • Your provider’s approval, if required.

You decide with your provider or clinical team1* what services you need. Your provider or clinical team may ask Cenpatico-IC for approval of a service for you, but the approval may be denied. If a request for services is denied, you can file an appeal. For more information on filing an appeal, see the section discussing appeals. You and your provider may not agree about the services you need. If you feel you need a service, and your provider does not, contact Cenpatico-IC at 1-866-495-6738 or TDD/TTY 1-877-613-2076. 1* Clinical Teams include both Child and Family Teams and Adult Recovery Teams The table below lists the available behavioral health services and any limits they may have. Cenpatico-IC must pay only for the available behavioral health services listed.

SERVICES TITLE XIX/XXI CHILDREN AND ADULTS NON-TITLE XIX/XXI PERSONS DETERMINED TO HAVE SMI
TREATMENT SERVICES
Behavioral Health Counseling and Therapy Individual Available Not Available
Group Available Not Available
Family Available Not Available
Behavioral Health Screening, Mental Health Assessment and Specialized Testing Behavioral Health Screening Available Not Available
Mental Health Assessment Available  
Specialized Testing Available Not Available
Other Professional Traditional Healing   Not Available**
Auricular Acupuncture   Not Available**
REHABILITIATION SERVICES
Skills Training and Development Individual Available Not Available
Group Available Not Available
Extended Available Not Available
Cognitive Rehabilitation Available Not Available
Behavioral Health Prevention/Promotion Education Available Not Available
Psycho Educational Services and Ongoing Support to Maintain Employment Psycho Educational Services Available Not Available
Ongoing Support to Maintain Employment Available Not Available
MEDICAL SERVICES
Medication Services*** Available Available
Lab, Radiology and Medical Imaging Available Available
Medical management Available Available
Electro-Convulsive Therapy Available Not Available
SUPPORT SERVICES
Case Management Available Not Available
Personal Care Available Not Available
Self-help/Peer Services Available Not Available
Home Care Training to Home Care Client (HCTC) Available Not Available
Unskilled Respite Care**** Available Not Available
Supported Housing Not available with TXIX/XXI funding** Not available to new members
Sign Language or Oral Interpretive Services Provided free of charge Provided free of charge
Flex Fund Services Not available with TXIX/XXI funding** Not Available**
Transportation Emergency Available Not Available
Non-emergency Available Not Available
CRISIS INTERVENTION SERVICES
Crisis Intervention - Mobile Available Available
Crisis Intervention - Telephone Available Available
Crisis Services - Stabilization Available Available
INPATIENT SERVICES
Hospital Available Provided based on available funding
Sub-acute Facility Available Provided based on available funding
Residential Treatment Center Available Not Available
RESIDENTIAL SERVICES
Behavioral Health Residential Facilities Level II Available Not Available
Level III Available Provided based on available funding
Room and Board   Not Available
BEHAVIORAL HEALTH DAY PROGRAMS
Supervised Day Available Not Available
Therapeutic Day Available Not Available
Medical Day Available Not Available

Limitations:
* For services available through federal block grants, please see the Special Populations section on page 27 of your member handbook.
** Services not available with TXIX/XXI funding, but may be provided if grant funding is available.
*** Medication services are limited for recipients who have Medicare.
**** Unskilled Respite Care – Respite care is offered as a temporary break for caregivers to take time for themselves. The number of respite hours available to adults and children receiving ALTCS benefits or behavioral health services is being reduced from 720 hours to 600 hours within a 12 month period of time. The 12 months will run from October 1 through September 30 of the next year.

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