The Seafarers Health and Benefits Plan (SHBP) recently spelled out new benefits for dependents of eligible SIU members.
Seafarers Plans Administrator Maggie Bowen in mid-May sent a letter notifying participants that the SHBP Trustees “decided to add mental health and substance use disorder benefits for dependents of eligible mariners at the Core-Plus and Core benefit levels. These services will be covered in the same way as all other professional services and inpatient hospital stays.”
The benefits took effect May 1, as follows, for the spouse and children of an eligible mariner at the Core-Plus or Core Benefit levels:
• Outpatient counseling and/or psychotherapy, including applied behavioral analysis (ABA) therapy treatment for autism. The Plan will pay for these services for a dependent in the same manner as other outpatient professional services. The Plan will pay 90% of the network-allowed amount for in-network treatment; or 65% of the reasonable and customary charge for out-of-network treatment.
• Hospitalization for mental health disorders. The Plan will pay for an inpatient hospital stay for a mental health condition of a dependent in the same way it pays for other hospital stays. At in-network facilities, the Plan will pay 100% of the network-allowed charge for the facility fee, and 90% of the network-allowed charge for professional fees. For out-of-network treatment, the Plan will pay 70% of the reasonable and customary charge for the facility fees, and 65% of the reasonable and customary charge for professional fee. There is a $450 copayment for all inpatient hospital stays.
• Inpatient detoxification from alcohol or drugs. The Plan will pay for inpatient detoxification for a dependent in the same way it pays for other hospital stays. A $450 copayment applies to this benefit.
• Inpatient substance use disorder treatment. The Plan will pay for inpatient substance use disorder treatment for a dependent in the same way it pays for other hospital stays. A $450 copayment applies to this benefit.
• Prescriptions for mental health and substance use disorders. The Plan will pay for these prescriptions in the same manner as it covers all other prescriptions. The letter also points out that all mental health and substance use disorder benefits are subject to the annual deductible. Questions may be directed to the Plan by phone at (800) 252-4674, option 3.
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