Peoples Health Coverage for Mental Health Care
If you’re enrolled in a Peoples Health Medicare Advantage plan (HMO, HMO-POS, PPO, or a Dual Eligible Special Needs Plan), behavioral health benefits are available for conditions like anxiety, depression, bipolar disorder, PTSD, psychosis, and co-occurring substance use. Exact coverage and costs vary by plan, so the best first step is to verify your benefits and confirm in-network providers.
Table of Contents
What Peoples Health Covers for Behavioral Health
Peoples Health Medicare Advantage plans include comprehensive behavioral health coverage that addresses both mental health and substance use disorders. These benefits vary depending on the plan type, such as HMO-POS, PPO, Dual Eligible Special Needs (D-SNP), or Group Medicare. In general, Peoples Health plans cover inpatient mental health hospitalization, outpatient therapy and psychiatry, and telehealth behavioral health services. For inpatient care, many plans include daily copays for the first few days of hospitalization.
Outpatient services are widely supported across Peoples Health plans, covering therapy, counseling, and psychiatric medication management for both mental health and substance use conditions. In addition to traditional office visits, Peoples Health includes supplemental telehealth benefits that allow members to access mental health and substance use disorder services virtually.
Every year, Peoples Health publishes updated member resources and plan documents, including benefit summaries, formularies, and Evidence of Coverage booklets. These documents outline all behavioral health cost-sharing details, coverage limits, and authorization requirements. Members are encouraged to review their plan’s current member resources and plan documents to understand exactly how their behavioral health benefits apply.
Using Your Peoples Health Plan for Mental Health Treatment
What We Treat
Coverage typically extends, when medically necessary, to:
- Depression (including persistent depressive disorder)
- Anxiety Disorders (GAD, panic, social anxiety, OCD)
- Bipolar Disorder
- PTSD and Trauma-related Disorders
- Personality disorders
- Schizophrenia, schizoaffective, and other psychotic disorders
- Co-occurring Substance Use (dual diagnosis)
Levels of Care We Can Help You Access
Depending on your plan and clinical need, Peoples Health documents reference benefits across
- Standard Outpatient (OP): individual therapy, medication management
- Telehealth: many plans allow virtual behavioral health visits (cost share varies)
- Intensive Outpatient Program (IOP) / Partial Hospitalization Program (PHP): when clinically appropriate and covered by your plan
- Inpatient Psychiatric Hospitalization: When hospitalization is necessary
Specific copays/coinsurance and day limits are plan-specific; consult your plan’s Summary of Benefits/EOC.
Not Sure What Your Peoples Health Plan Covers? We Can Help
Verify Your Insurance Benefits
Using Your Peoples Health Plan for Mental Health Treatment
In-Network First:
Using in-network providers generally lowers costs. Peoples Health publishes provider and plan resources for members annually.
Prior Authorization:
Routine outpatient therapy often does not require prior authorization, while higher-intensity services (e.g., IOP, PHP, inpatient) may, per plan rules. We verify this before scheduling. (See your EOC for the binding requirements.
Telehealth:
Many Peoples Health plans include behavioral health telehealth coverage; check your plan’s Summary of Benefits for your specific cost share.
What Costs Should I Expect with Peoples Health
Your cost share depends on:
- Your plan (HMO/HMO-POS/PPO, D-SNP, Group Medicare)
- Service type (OP therapy, telehealth, IOP/PHP, inpatient)
- Network status (in-network vs. out-of-network, if applicable to your plan)
- Any deductible, copay/coinsurance, and authorization requirements
Peoples Health publishes plan-specific copays/coinsurance in the Summary of Benefits (e.g., inpatient/outpatient mental health details for PPO/HMO-POS and Group plans). Use your plan’s current booklet for exact amounts.
Verify Your Peoples Health Benefits
Have your:
- Member ID and group number
- Full name, date of birth, and address on the policy
- Clear photos of the front and back of your ID card
We confirm eligibility, covered levels of care, any required authorizations, and estimated costs. We also schedule your first appointment.
Common Mental Health Conditions Covered by Peoples Health Plans
Depression
Individual therapy, medication management, group therapy/support
Generalized Anxiety and Panic Disorder
CBT, exposure therapy, psychiatric evaluation and medication.
Bipolar Disorder
Psychiatric evaluation, mood stabilizers, ongoing monitoring, therapy.
PTSD and Trauma-Related Disorders
Psychiatric evaluation, mood stabilizers, ongoing monitoring, therapy.
Attention-Deficit/Hyperactivity Disorder (ADHD)
Behavioral therapy, coaching, medication monitoring.
Obsessive-Compulsive Disorder (OCD)
Exposure and Response Prevention (ERP), CBT, psychiatric oversight.
Schizophrenia / Schizoaffective Disorder
For individuals with more than Psychiatric hospitalization, long-term medication oversight, supportive therapy.
Co-occurring Mental Health & Substance Use Disorder
Integrated therapy, dual-diagnosis programs, medication-assisted treatment.
Find Out if Your Highmark Plan Covers Treatment
Considering outpatient mental health care with Peoples Health? Start with a benefits check, we’ll handle it for you.
FAQs: Peoples Health & Mental Health Coverage
Will Peoples Health cover IOP or PHP?
Many plans do so when medically necessary and authorized (if required). Coverage and cost share vary by plan; we confirm before scheduling.
Is inpatient psychiatric hospitalization covered?
Peoples Health materials list inpatient mental health benefits in several plans (including Group Medicare and certain D-SNP/HMO-POS options). Check your plan booklet for exact cost sharing and day ranges.
What if I’m in a Group Medicare (employer) plan?
Group Medicare plan pages detail behavioral health coverage (inpatient/outpatient). See your group plan’s Summary of Benefits.
Do you accept Peoples Health for therapy and psychiatry?
Yes, when your plan includes those benefits and the provider is in network. We verify eligibility before your first visit. Refer to your plan’s Summary of Benefits/EOC for specifics.
Can I use telehealth for behavioral health?
Yes, many Peoples Health plans include telehealth behavioral health visits; see your plan’s Summary of Benefits for rates.
Related Mental Health Insurance Information
Looking for more details about insurance providers accepted for outpatient mental health treatment? Explore how different plans may support access to care:
Aetna
AmeriHealth
Blue Cross Blue Shield
Anthem Blue Cross
Premera Blue Cross
Anthem BCBS
Empire BCBS
Regence BCBS
Beacon Health Options
Blue Shield of CA
Carelon Behavioral Health
Cigna
ComPsych
Elevance Health
First Choice Health
First Health Network
GEHA
Halcyon
Health Net
HMC Networks
Humana
Kaiser
Magellan
Meritain Health
MHN Health Net
MultiPlan
NYSHIP
Optum
UMR
UHC
Value Options
Wondering How Your Coverage Works?
Medically Reviewed By: Shahana Ham, LCSW
Shahana Ham, LCSW, is a Licensed Clinical Social Worker with a Master’s in Social Work from the University of Southern California. She specializes in client-centered care for individuals facing mental health and substance use challenges, fostering a supportive environment for healing and growth.
