Tufts Health Insurance Coverage for Mental Health Care
Table of Contents
What Tufts Health Plan Offers for Behavioral Health
Tufts Health Plan offers comprehensive behavioral health benefits that include coverage for both mental health and substance use disorders across many of its plan types. Members can typically access outpatient counseling and therapy, inpatient mental health and substance use disorder services, and telehealth options such as virtual therapy and psychiatry. Plans also support specialized programs for substance use disorder, including detoxification, medication-assisted treatment, counseling, and peer support. In addition, Tufts provides behavioral health navigation and care coordination services that connect members with service navigators, case management, and ongoing support resources.
Because coverage scope, cost-sharing, and network participation vary depending on the specific Tufts plan, whether employer-sponsored, individual, or public. It’s important to verify your exact benefits before starting care. You can use Tufts’ “Find a Doctor / Find a Provider” tool to locate in-network therapists, psychiatrists, and mental health specialists.
What We Treat
Our practice supports a broad array of mental health and co-occurring substance use conditions, commonly accepted under Beech Street:
- Generalized anxiety, panic disorder, social anxiety, OCD
- Major depressive disorder, persistent depressive disorder, bipolar spectrum
- PTSD, complex trauma
- Thought disorders, schizophrenia, schizoaffective
- Personality disorders
- Co-occurring substance use disorders, dual diagnoses
Before starting care, we verify whether your particular diagnosis and recommended treatment levels are supported under your plan and network
Levels of Care We Can Help You Access
Depending on clinical need and what your Tufts plan covers, you may be able to access a variety of care:
- Standard Outpatient (OP): Weekly or biweekly therapy, medication check-ins
- Intensive Outpatient Program (IOP): Several sessions per week while living at home
- Partial Hospitalization Program (PHP): Day treatment, structured like a hospital level of care
- Telehealth/Virtual Care: Remote therapy or psychiatry sessions
- Referral to higher care: If your needs exceed what we offer, we coordinate referrals to in-network facilities
- Transition Management: Ongoing support and coordination to help you move smoothly between levels of care, ensuring continuity, stability, and long-term recovery success.
We help navigate which levels your insurance will support, and assist with authorizations, provider referrals, and scheduling, so your treatment begins without surprises.
Not Sure What Your Tufts Health Plan Covers? We Can Help
Verify Your Insurance Benefits
Using the Your Tufts Health Plan for Mental Health Treatment
- Outpatient Counseling/Therapy
Tufts Health Plan covers outpatient counseling and therapy sessions that help individuals manage mental health conditions in a flexible setting. These services typically include one-on-one or group sessions with licensed mental health professionals, focusing on evidence-based approaches such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or trauma-informed care, depending on clinical need. Learn more and understand your behavioral health benefits. - Telehealth/Virtual Therapy/Psychiatry
Members can access licensed therapists and psychiatrists through Tufts Health Plan’s telehealth services, receiving confidential care from home via secure video sessions. These virtual appointments cover therapy, medication management, and psychiatric evaluations, making behavioral health support more accessible and convenient. - Programs for Substance Use Disorder
Tufts Health Plan includes benefits for substance use treatment programs that may involve medically supervised detoxification, ongoing counseling, medication-assisted treatment, and peer recovery support. These services help individuals safely manage withdrawal, build coping skills, and maintain long-term recovery. - Behavioral Health Navigation/Coordination
Members have access to care coordination services that connect them with appropriate providers, programs, and community resources. Tufts Health Plan’s behavioral health navigators and care managers help ensure members receive the right level of care, streamline referrals, and support continuity
What Costs Should I Expect with Tufts Health?
Your out-of-pocket responsibility will depend on several factors:
- Your copays, coinsurance, and deductible for behavioral health services will depend on your specific Tufts plan.
- For example, in the Tufts Health Direct Gold plan’s summary, individual therapy/counseling has a $30 copayment per visit, with no prior authorization required, under in-network providers.
- Out-of-network services may incur higher cost shares or may not be covered, depending on the plan
After verifying your benefits, we provide a personalized cost estimate so you’ll have a clear understanding of your expected expenses before starting treatment.
Verify Your Tufts 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.
To speak with someone about using Tufts health insurance for mental health treatment, you can verify your benefits here.
Common Mental Health Conditions Covered by Tufts
Tufts Health Plan provides coverage for a broad range of mental health and substance use disorders through its behavioral health benefits. Members have access to in-network providers who offer therapy, psychiatry, medication management, and structured outpatient care. Coverage and costs vary by plan type, and eligibility is verified before treatment begins.
Depression
Tufts Health Plan covers outpatient treatment for depression, including individual therapy, group counseling, and medication management. Members can receive evidence-based care for both major depressive disorder and persistent depressive disorder, with treatment plans developed by licensed clinicians.
Generalized Anxiety and Panic Disorder
Coverage typically includes therapy and psychiatric care for anxiety-related conditions such as generalized anxiety disorder, social anxiety, and panic disorder. Treatment often involves Cognitive Behavioral Therapy (CBT), mindfulness-based therapy, and medication management when medically necessary.
Bipolar Disorder
Tufts Health Plan supports care for bipolar disorder through outpatient and structured programs. Covered services may include psychiatric evaluations, mood stabilization therapy, and regular medication monitoring to support long-term symptom management.
PTSD and Trauma-Related Disorders
Members can access trauma-informed care, supportive therapy, and evidence-based treatments such as Cognitive Processing Therapy (CPT) or Eye Movement Desensitization and Reprocessing (EMDR) when covered under their plan. These services are designed to reduce distress and promote emotional recovery after trauma.
Attention-Deficit/Hyperactivity Disorder (ADHD)
Tufts Health Plan covers behavioral therapy, executive function coaching, and medication management for ADHD. Services are available for both children and adults, provided by licensed professionals specializing in attention and behavioral regulation.
Obsessive-Compulsive Disorder (OCD)
Treatment for OCD may include Exposure and Response Prevention (ERP) therapy, cognitive-behavioral interventions, and psychiatric care. Tufts Health Plan helps members connect with in-network providers trained in evidence-based OCD treatment approaches.
Schizophrenia and Schizoaffective Disorder
Plans include coverage for psychiatric stabilization, medication management, and supportive therapy for individuals managing thought disorders. Tufts Health Plan ensures access to coordinated care focused on safety, stability, and ongoing recovery.
Co-Occurring Mental Health and Substance Use
Integrated treatment for dual diagnoses is available and often considered medically necessary. Tufts Health Plan supports comprehensive approaches that address both mental health and substance use concerns simultaneously to improve long-term outcomes.
Note: Coverage under Tufts Health Plan depends on your specific plan type, diagnosis, and medical necessity criteria. Verifying your benefits is the best way to understand which mental health services are available to you.
Find Out if Your Tufts Health Plan Covers Treatment
If you’re considering outpatient mental health treatment and currently have a Tufts Health Plan, taking the time to verify your benefits is a helpful first step.
FAQs: Tufts Health Plan & Mental Health
Do you accept Tufts Health Plan for therapy/psychiatry?
Yes, if your provider is in-network under your specific Tufts plan. We verify this before scheduling.
Will Tufts cover IOP or PHP?
Many Tufts plans cover higher-intensity outpatient or day treatment when medically necessary; we check prior authorization requirements.
What if my provider is out-of-network?
You may face higher costs; some plans offer partial out-of-network coverage, but benefits are more favorable when you stay in-network.
Do I need a referral or authorization?
For standard outpatient therapy, you typically do not need a referral. But more intensive services may require prior authorization.
Does Tufts cover co-occurring addiction and mental health treatment?
Yes. Tufts covers substance use disorder services (counseling, medication, detox, therapy) and integrated behavioral health care.
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.
