Partial Hospitalization Outpatient Rehab Covered by Carelon in Dallas, Texas
A Partial Hospitalization Program (PHP) is an intensive outpatient treatment option that has proven to be highly effective in many circumstances. A PHP is one outpatient rehab covered by Carelon Health Services and offered at BreakThrough by BasePoint. Our highly skilled and experienced mental health professionals offer care for depression, anxiety, OCD, PTSD, and many other mental health conditions.
When you call BreakThrough by BasePoint at 972-325-2633, our admission specialist can answer many of your questions about our day treatment programs, inpatient and virtual treatment options, and verify your insurance coverage. You can also schedule a free and confidential assessment with treatment recommendations, ensuring you have the necessary information to make an informed choice about your mental health care.
What Is a PHP for Mental Health Treatment?
A partial hospitalization program is an intensive, structured outpatient mental health option that provides comprehensive care while still allowing you to return home at the end of each day. A PHP offers the highest level of outpatient therapy, typically comparable to what you would receive as an inpatient. This is ideal when you do not require 24/7 hospitalization.
The programs typically include individual, group, and family counseling, medication management, and skill-building sessions to help you manage mental health conditions. A PHP can be a step-down program used after hospitalization or your initial program when traditional outpatient therapy is not enough. Ultimately, the goal is to stabilize your symptoms, help you develop coping strategies, and work toward transitioning to a lower level of care. When you or a loved one needs structured mental health support, a partial hospitalization program center may be a beneficial option. Call BreakThrough by BasePoint today below for information about our programs and to verify your insurance coverage. These are the initial steps that help streamline your admission process.
Who Is the PHP Insurance Provider Carelon?
Carelon is a healthcare services company formerly known as Beacon Health Options but rebranded Carelon Behavioral Health in 2023. The company brings together a portfolio of businesses with over 150 years of collective experience. They are a subsidiary of Elevance Health and offer a wide range of services from pharmacy, behavioral health, and operations and technology services.
As part of the Elevance Health brand, Carelon is an integrated health services and care delivery system for Medicare and Medicaid patients. They focus on providing proactive, integrated care using coordination, education, and disease management programs. The comprehensive suite of services is aimed at transforming your care by connecting various aspects of the healthcare system that improve your health outcomes.
BreakThrough by BasePoint Accepts Carelon PHP Insurance
Our free assessment with a licensed clinician will provide you with a recommendation for the appropriate level of care for young adults struggling with a mental health disorder. We can also check your Carelon PHP mental health coverage levels.
Call us today to schedule a same day assessment at (972) 325-2633 or fill out our inquiry form.
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What Is Carelon PHP Treatment Coverage?
Carelon Behavioral Health policies typically cover Partial Hospitalization Programs (PHPs) when you require intensive mental health treatment but don’t need 24/7 supervision. The programs offer structured, short-term, outpatient psychiatric care, including medical and nursing supervision. They are designed as an alternative to inpatient care, where you can safely live at home.
Coverage for PHP services typically varies between health plans and policies. Your coverage depends on the plan you purchased and can have regional differences. For example, participants in Maryland may have different benefits than those living in New York or Texas. You can easily verify your coverage details and requirements by calling BreakThrough by BasePoint at 972-325-2633. Our admission specialist can also help you understand your coverage details, describe our day treatment centers’ programs, and offer you a free and confidential assessment with treatment recommendations.
Which Mental Health Disorders Are Covered by Carelon Plans for PHP in Dallas?
Young adults experience a variety of mental health conditions or substance use disorders that are impacted by the transitional life stage of young adulthood. The following are several types of mental health conditions covered by Carelon, but it is not a full list. Call or contact us today for more information about treatment and to verify your insurance coverage.
Anxiety disorders are among the most prevalent mental health conditions, characterized by excessive worry that can interfere with your daily life. You might experience symptoms like restlessness, fatigue, difficulty concentrating, and sleep disturbances. Effective treatment usually involves a combination of psychotherapy, medication, and lifestyle modifications.
Carelon behavioral health plans offer coverage for various mental health treatments, including partial hospitalization programs, when you have an anxiety disorder. PHP provides intensive structured therapy that serves as a bridge between inpatient and outpatient care. However, you must know your benefits under your policy before beginning treatment, so you don't receive an unexpected medical bill. When you call BreakThrough by BasePoint at 972-325-2633, we can help.
Trauma-related disorders, such as Post-Traumatic Stress Disorder (PTSD), can result from witnessing or experiencing a distressing or traumatic event. It can lead to symptoms like flashbacks, nightmares, and emotional numbness. Effective treatment typically includes psychotherapy, medication management, and support groups to help you process the experience and develop coping strategies.
Carelon health insurance plans usually provide coverage for Partial Hospitalization Programs (PHPs) designed to treat trauma-related disorders. This offers you an intensive and structured therapy program during the day while still allowing you to return home in the evening. Programs may include individual, group, and family counseling, and specialized trauma-focused interventions. Your coverage specifics depend on your insurance plan. Call BreakThrough by BasePoint today at 972-325-2633 for information about our programs and to verify your insurance coverage. We can identify the factors that influence your out-of-pocket expenses.
Depression is a prevalent mental health condition marked by persistent feelings of sadness and a range of emotional and physical problems that can impair your daily functioning. You can experience symptoms of changes in appetite and sleep, fatigue, difficulty concentrating, and self-harm. Your PHP may include medication management, psychotherapy, and lifestyle adjustments to improve your quality of life.
Carelon Behavioral Health policies usually provide coverage for partial hospitalization programs tailored to your needs while you're battling depression. These intensive day treatment services include individual, group, and family counseling that allow you to participate while returning home in the evenings. A PHP is a critical bridge between inpatient and outpatient care, offering substantial support without full hospitalization. Your coverage details provide important information about the documentation needed to receive the maximum benefits under your plan. Call BreakThrough by BasePoint today at 972-325-2633 to verify your insurance coverage and understand the coverage details.
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after you have witnessed or experienced a distressing event. You might experience symptoms like intrusive memories, flashbacks, emotional numbness, and heightened anxiety. Effective treatment combines psychotherapy with medication management and support groups to help you process the trauma and develop healthy coping strategies.
Carelon insurance policies often provide coverage for Partial Hospitalization Programs (PHPs) designed to treat PTSD. However, your coverage details depend on the health insurance plan you purchased and influence your out-of-pocket expenses. When you call BreakThrough by BasePoint at 972-325-2633, our admission specialist can verify your insurance coverage and determine if you require in-network providers or prior authorization. Understanding your coverage details and working within the documentation requirements of the insurance plan helps you receive the maximum benefits under your insurance policy. We are here to help.
Personality disorders are a group of mental health conditions that are characterized by behaviors, thinking patterns, and inner experiences that are vastly different from cultural expectations. This can lead to distress or impairment in your personal, social, or occupational functioning. Examples include borderline personality disorder, narcissistic personality disorder, and obsessive compulsive disorder.
Each has unique symptoms and requires specific treatment. Carelon health insurance policies typically offer some coverage for a PHP tailored to treat personality disorders. However, the extent of the coverage, benefits, limitations, and possible exclusions or endorsements to your policy depend on the plan you purchased. When you call BreakThrough by BasePoint at 972-325-2633, our admission specialist can speak with you about Carelon partial hospitalization program insurance coverage, verify your policy details, and work with you on the factors that influence your out-of-pocket expenses.
Obsessive Compulsive Disorder (OCD) is a chronic condition characterized by persistent and uncontrollable thoughts called obsessions, and repetitive behaviors or mental acts called compulsions. You may feel compelled to perform the compulsions to alleviate anxiety or distress triggered by obsessions. An obsession might include fear of contamination or harm, while compulsions could involve excessive hand washing or checking.
The symptoms are often time-consuming and disrupt relationships, work, and overall quality of life. Carelon Behavioral Health policies generally cover partial hospitalization programs designed to treat symptoms of obsessive compulsive disorder. These are ideal when you need more support than traditional outpatient therapy but don't require 24/7 hospitalization. There are coverage specifics that influence your out-of-pocket expenses, which you must know since they vary by plan. When you call BreakThrough by BasePoint at 972-325-2633, our admission specialist can verify your insurance coverage and help you receive the maximum benefits in your plan.
Dual diagnosis is also known as a co-occurring disorder. It is the presence of both a mental health disorder and a substance use disorder. This may include an alcohol addiction and depression or an opioid dependency and anxiety, to name a few. This requires integrated and specialized care since the conditions often exacerbate each other.
A substance abuse PHP treatment program may offer help for dual diagnosis, including symptoms that may overlap between withdrawal and mental health conditions. Carelon health insurance plans may offer some coverage for a day treatment for addiction recovery and mental health treatment that addresses both conditions simultaneously. The program seeks to stabilize your symptoms, address addiction triggers, and build coping skills. It can serve as a bridge between inpatient treatment and standard outpatient care. Call BreakThrough by BasePoint today to learn more about our outpatient PHP rehab programs, verify your insurance coverage, and get guidance to receive the maximum benefits under your insurance policy.
How to Check My Carelon Health Insurance Plan Coverage at BasePoint
The easiest way to check your Carelon health insurance plan coverage is to call BreakThrough by BasePoint below. Our admission specialist can verify your insurance coverage and help you understand the details that influence your expenses. When you call, we will ask for your insurance ID number, which you can find on your insurance card or policy documents.
This simple step will help you understand your coverage benefits and limitations, which allows us to give you an estimate of your potential out-of-pocket costs up front. We are here to help you navigate this process with confidence. You can call us or fill out our insurance inquiry form to get the information you need. We can connect you with our financial counselor who may have financial assistance opportunities when you qualify.
How to Get Carelon to Pay for Mental Health PHPs in Dallas
The best way to get Carelon to pay for your day treatment for adults to address your mental health or dual diagnosis is to know and understand your insurance plan coverage specifics. When you call BreakThrough by BasePoints, we can verify your insurance coverage and help you understand the benefits and limitations that affect your out-of-pocket costs.
Our caring admission specialist verifies your benefits and determines if prior authorization is needed. We handle all the details for you. It’s helpful to understand the key insurance terms when identifying your benefits and limitations. Your insurance company begins by using an underwriting process in which they evaluate certain factors in your physical and mental health that help determine their risk and liability in writing an insurance policy.
An actuary uses this information to calculate the probability of loss and then sets the premiums. Your insurance plan may have an exclusion that places additional limits on the coverage or an endorsement that can modify your policy to meet your needs better. After receiving care, a claim is submitted to your insurance company, and an insurance adjuster evaluates the information to determine the loss to the insurance company and the appropriate settlement or payment that should be sent.
Your insurance plan may also have an umbrella policy that provides extra coverage beyond the standard limits. When you work with BreakThrough by BasePoint, our admission specialist can identify these factors and help you understand how they impact your out-of-pocket expenses.
How Many Times Will Carelon Health Insurance Pay for Mental Health PHPs in Dallas, Texas?
The number of times that your Carelon health insurance plan pays for a mental health PHP or PHP addiction treatment program depends on your plan’s benefits and limits. For example, some plans limit the number of times you can receive therapy in a year, while others may limit the type of therapy you can receive.
Generally, health insurance plans cover a PHP for substance abuse or mental health treatment when it is medically necessary. They may require prior authorization, which means you must submit documentation to prove medical necessity for the carrier you’re receiving. They will prior authorize a certain number of treatment episodes or days based on your diagnosis and your policy. BreakThrough by BasePoint will work with your insurance company to help you receive the maximum amount of benefits under your policy that is medically necessary to achieve mental health and wellness.
Call us today at 972-325-2633 for information about our programs and to verify your insurance coverage. We will handle the paperwork for you to make the process as smooth and stress-free as possible. We want you to know that you are not alone. BreakThrough by BasePoint is here to help you access the care you need and deserve. Our support ensures that you have the time and energy to focus on healing and have a champion in your corner to overcome insurance hurdles.
Dallas Mental Health PHPs That Take Carelon Insurance Plans
BreakThrough by BasePoint is among the mental health facilities throughout Texas that work with Carelon insurance plans. Each facility is staffed with highly skilled clinicians, so you can receive care at any facility with confidence that you’re getting high-quality treatment. Call or contact us today for more information about our programs and how we can help meet your needs.
- Arlington, TX: 3900 Arlington Highlands Blvd Suite 237B Arlington, TX 76018
- Forney, TX: 713 W Broad St Suite 100 Forney, TX 75126
- Frisco, TX: 8275 Judges Way, Suite 100F, Frisco, TX 75036
- McKinney, TX: Virtual Mental Health Treatment
Arlington, Texas, was founded in 1876 between Dallas and Fort Worth. Today it has a population of just under 400,000 and ranks as the 50th largest city in the U.S. Arlington is renowned for attractions like the AT&T Stadium, home of the Dallas Cowboys, and Globe Life Field, where the Texas Rangers play.
- BreakThrough by BasePoint - Arlington, Texas: 3900 Arlington Highlands Blvd, Suite 237B, Arlington, TX 76018, United States
Forney, Texas, is located in Kaufman County, just 20 miles east of Dallas. The city has grown an estimated 51% since 2020. Forney offers unique shopping experiences and family-friendly attractions, including the Spellman Museum of Forney History and Forney Community Park.
- BreakThrough by BasePoint – Forney, Texas: 713 W Broad St, Suite 100, Forney, TX 75126, United States
McKinney, Texas, was established in 1848 and is a rapidly growing city that's just 30 miles north of Dallas. The city boasts a historic downtown area, offering various locally owned shops, restaurants, and entertainment venues. Notable attractions include the Heard Natural Science Museum & Wildlife Sanctuary, a 289-acre preserve featuring hiking trails and educational exhibits.
- BreakThrough by BasePoint - McKinney, Texas: 4733 Medical Center Drive, McKinney, TX 75069, United States
Frisco, Texas, is 25 miles north of Dallas and has experienced rapid growth in the past decade. Frisco is known as “Sports City USA,” hosting multiple professional teams, including FC Dallas and the Dallas Cowboys' headquarters. The city also offers cultural attractions like the Museum of the American Railroad and the National Videogame Museum.
- BreakThrough by BasePoint - 8275 Judges Way, Frisco, TX 75036 Suite 100F
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Does Carelon Health Insurance Cover Mental Health PHPs for Young Adults Near Me?
Carelon outpatient mental health coverage can include Partial Hospitalization Programs (PHPs) tailored for young adults who require intensive mental health care without 24/7 supervision. PHPs provide structure, short-term outpatient treatment that can meet your needs when you have significant mental health challenges and a stable home environment. Carelon partial hospitalization program coverage in Dallas depends on your policy.
You must understand your coverage details before starting treatment so you don’t receive an unexpected medical bill. When you work with BreakThrough by BasePoint, our admission specialist can verify your insurance coverage and help you understand many of the factors that influence out-of-pocket costs, such as your premiums, deductibles, copays, network provider status, and prior authorization requirements. When you call, we can also offer a free and confidential assessment with treatment recommendations, so you are fully prepared with the information needed to make an informed treatment decision.
Does Carelon Health Insurance Cover Dual-Diagnosis PHPs in DFW?
Carelon’s partial hospitalization program insurance is typically part of your health insurance policy. This policy covers many of the aspects of a PHP tailored for individuals with dual diagnosis. A dual diagnosis is the term used to describe an individual who has two mental health diagnoses, typically a substance use disorder and a co-occurring mental health condition.
These dual diagnosis programs are specialized to address both conditions simultaneously, which promotes comprehensive recovery. You must understand your coverage specifics, which depend on your health plan. When you call BreakThrough by BasePoint at 972-325-2633, our admission specialist can describe to you our partial hospitalization programs and Intensive Outpatient Programs (IOPs) designed to meet the unique needs of young adults.
Does Carelon Insurance Cover PHP Therapy and Counseling in Dallas, Texas?
Therapy and counseling are typically part of traditional outpatient treatment and intensive structured treatment programs such as a partial hospitalization program or Intensive Outpatient Program (IOP). Therapy and counseling are integral parts of PHP drug treatment and mental health treatment programs. However, your coverage details depend on the plan you purchased.
BreakThrough by BasePoint works with Carelon insurance, and our admission specialists are adept at meeting your plan’s documentation requirements, so you receive the maximum benefits under your policy. When you call us below, our admission specialist will verify your insurance coverage, answer your questions about our day treatment centers programs, and offer you a free assessment and evaluation with treatment recommendations.
Does Carelon Cover Online PHPs in Texas?
Carelon outpatient mental health coverage often includes benefits for virtual care. These intensive outpatient programs offer structured treatment that typically includes individual, group, and family therapy, skills-building workshops, and medication management. However, your coverage depends on your insurance plan. Your out-of-pocket expenses are influenced by your insurance premiums, deductible, copay, network status, and prior authorization requirements.
You should understand your coverage specifics to determine the benefits available in your policy. This is quickly and easily done by calling BreakThrough by BasePoint at 972-325-2633, so our admission specialists can verify your insurance coverage and determine the details necessary to receive the maximum benefits under your policy. We can also offer a free and confidential assessment, so you have the information you need to make an informed healthcare decision.
Does Carelon Cover Evening PHPs in Dallas, Texas?
Yes, Carelon health insurance generally provides coverage for Partial Hospitalization Programs (PHPs), including those that have evening schedules. However, because of the intensity of the program, most PHPs require at least some daytime treatment. An Intensive Outpatient Program (IOP) may offer greater flexibility with evening hours but does not offer the intensity level you may require.
Your coverage specifics, such as eligibility and prior authorization requirements, depend on your healthcare plan. You can determine your exact benefits by calling BreakThrough by BasePoint at 972-325-2633 and speaking with our admission specialist. They can identify the factors that influence your out-of-pocket expenses, and the documentation needed to receive the maximum benefits in your policy. Carelon typically provides day treatment benefits for adolescents and young adults covered in the insurance policy. BreakThrough by BasePoint can also offer a free assessment to identify the level of care needed to address your mental health condition.
The first step to getting Aetna insurance to pay for your virtual mental health therapy in Texas is to verify your plan details and understand what virtual counseling services are covered. Start by contacting BreakThrough by BasePoint at 972-325-2633. Our admission specialist will review your policies and benefits for mental health services, including online treatment and remote psychotherapy.
They will also determine if prior authorization is required before you begin treatment and if we are in network with your Aetna plan. Our admission specialist can handle specifics of verifying coverage, estimate your potential out-of-pocket expenses, and offer a free assessment with treatment recommendations so you have the necessary information you need to make an informed decision about receiving virtual mental health services at BreakThrough by BasePoint.
- Partial hospitalization programs and intensive outpatient programs are structured outpatient treatment options. A PHP provides an intensive level of care comparable to treatment in a residential center while allowing you to live at home.
- A study comparing in-person and virtual partial hospitalization programs found a PHP delivered completely via telehealth had excellent outcomes, with a higher attendance rate and lower hospitalization rate. However, since it was not an experimental study, there may have been other factors that were responsible for the results.
- A study of military personnel who completed a 6-day partial hospitalization program found that these programs can help meet the growing demand for mental health care in active duty and retired military personnel who require intensive outpatient treatment.
- People with borderline personality disorder experience wide mood swings and display a great sense of instability and insecurity. Extreme emotions and impulsive behaviors are difficult to prevent or control. One randomized controlled trial demonstrated that a PHP is far superior to standard psychiatric care.
- In 2023, the percentage of adults who were diagnosed with depression at some point in their life reached 29%, which was 10% greater than in 2015. Adults with a depressive disorder have a 64% higher risk of developing heart disease. Evaluating the results of a PHP in older adults was highly effective, with 80% of participants demonstrating improved function.