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Behavioral Health Benefits

AmeriHealth Caritas Iowa members can get behavioral health services. Behavioral health services can help you with:

  • Mental illness.
  • Drug use.
  • Alcohol use.

If you think you need these services, talk to your primary care provider (PCP). This is the best place to start. Tell your PCP how you feel. Ask about behavioral health providers who can help.

You can find behavioral health and substance use disorder providers with Search for a provider. Or call Member Services at 1-855-332-2440 (TTY 1-844-214-2471) 24 hours a day, 7 days a week.

Covered behavioral health services

These services are covered by your Iowa Medicaid plan. These services need to be medically necessary to be covered. Your benefits and services depend on your age and the Medicaid plan you are in.

Addiction services: These services help you stop using alcohol or drugs. You might get these services in a hospital. If you use these services, you may have to stay at the program overnight.

Behavioral health outpatient services: These are planned, regularly scheduled visits to a doctor, counselor or therapist. You will talk about your behavioral health issues. This can include:

  • Individual, family and group therapy.
  • Psychological and/or neuropsychological testing.

Inpatient hospitalization for mental health and substance use disorders: This is the most serious care you can get. This is care you get in a hospital. You may be hospitalized if:

  • You are at risk of harming yourself or others.
  • You experience a behavioral health crisis.
  • Your medicines need to be watched closely.
  • Other care didn’t help your problem.

Psychiatric medical institute for children (PMIC): This service is for members younger than 21 years old. It provides long-term, 24-hour care in a group living facility.

Community-based services

These services help you live and work in your community. They help you manage symptoms that keep you from living as best as you can.

Assertive community treatment (ACT): This service is for adults with serious mental illness. A team of providers will work with you where you live. Services can include:

  • Counseling.
  • Substance use disorder therapy.
  • Housing assistance.
  • Help with your medicines.

Autism services

You can get services if you have autism spectrum disorder, such as:

  • Applied behavior analysis.
  • Family counseling.
  • Parent training.
  • Physical therapy.
  • Speech therapy.
  • Occupational therapy.

Behavioral health intervention services (BHIS): These services help you live well in your community. If you are 18 years old or older, you can get training to learn new skills. If you are 20 years old or younger, you can get help with:

  • Health issues.
  • Behavior issues.
  • Family issues.
  • Emergencies.

Community support services: These services help you live and work in your community. They help you manage symptoms to improve your health. You can get rides to these services.

Crisis intervention/stabilization: This is to help you in a crisis, or emergency. These services help keep you from needing an emergency room or a hospital. You can use these services at any time. You can get a ride for this service. If you are in a crisis, call Member Services at 1-855-332-2440 24 hours a day, 7 days a week. If it is an emergency, call 911.

Habilitation services: This is a program that offers home and community-based services (HCBS) to Iowans with functional injuries usually related to chronic mental illnesses. These services help you get, keep and improve the self-help, social and adaptive skills you need to live well in home and community-based settings.

Services include:

  • Home-based habilitation:
    These are services offered your home and community. This includes help with medication management, budgeting, grocery shopping and personal hygiene skills.
  • Day habilitation:
    These are services that are usually given in a day program outside the home. This focuses on areas such as social skills, communication skills and behavior management.
  • Prevocational services:
    These can be given in many settings. They focus on developing skills that get your ready  for employment. Typical examples include attendance, safety skills, following directions and staying on task.
  • Supported employment:
    These help you get and keep a job in your community. This can place you in a job in a regular work setting. You will be with people without disabilities. You will make minimum wage or higher. You will get support to maintain your job. Examples include skills assessments, consultation with the employer, job coaching and behavior management.

Home- and community-based services: This gives individualized benefits to members who are older or have disabilities. The benefits allow them to live in their own home or community when they would otherwise need care in a nursing facility or other place. This gives you more choices about how and where you get services. These services may allow you to stay in your home. You must be eligible for Medicaid. You also meet the requirements for the waiver you are applying for or receiving. You will need to meet certain requirements that show you are in need of a:

  • Nursing facility, 
  • Skilled nursing facility, or 
  • Hospital care or care in an intermediate care facility for individuals with intellectual disabilities.

Intensive psychiatric rehabilitation (IPR): This service helps you meet your goals and stay in your community with family and friends. You will get help in day-to-day life skills and goals.

Peer support services (PSS): These are services you get from a peer support specialist (PSS). The PSS can help you in your home or community. They speak up for your needs. The PSS offers you support during emergency, outpatient, and inpatient care. The PSS can also help you as you leave a 24-hour level of care.

Do you have questions about these services? Talk to your PCP to find what’s right for you. If you have questions about AmeriHealth Caritas Iowa, call Member Services at 1-855-332-2440 (TTY 1-844-214-2471) 24 hours a day, 7 days a week.