When parents need to get behavioral health care for troubled teens, the search may be more involved than just finding a provider in your child’s plan network.
The good news is, there have been advancements in the field. Many behavioral health care providers specialize in certain areas, so you can find just the right fit for your teen.
However, that may mean that finding care options that fit your teen’s needs will involve some research. Research can take time, and you may not know where to start or what to ask. So we have a short list of questions that may help make the process easier.
Getting Care for Teens
To get started in your research to find the right behavioral health provider for your teen, here are some questions you may want to ask when looking for a provider:
- Are you in my network?
- Do you treat teenagers?
- Are you taking new patients?
- How long do I have to wait for an appointment?
- Are you affiliated with any facilities in the area?
- Do you treat dual diagnosis patients?
You may find answers to the first three questions using our Provider Finder® online tool. To access Provider Finder, log in to Blue Access for MembersSM and click the Find a Doctor or Hospital tab.
If you can’t find all of the answers to the first three questions in Provider Finder, you’ll probably need to call the providers. And you’ll probably need to call for answers to the last three questions, too.
Keep in mind that there can be a long wait for appointments, weeks if not months, for some providers. And not all providers treat dual diagnosis patients.
Can It Wait?
Providers who treat teens are in high demand. For some providers, there may be a longer wait time for an appointment than you expect.
There are situations when treatment is needed sooner. Each situation is different, and several factors need to be considered.
If you just feel that something may be off and you want a professional opinion for peace of mind and there is no family history of behavioral health issues and no indication of self-harm, violence or substance abuse, then waiting for an appointment may be fine.
But if any of these problems are happening and the situation seems or becomes more urgent, you may need to get care as soon as possible.
If your situation is urgent, call the number on the back of your member ID card to get help finding a program. And always call 911 first if you believe self-harm or harm to others may be imminent.
Some Coverage Basics and Tips
In addition to finding the right provider and treatment for your teen, you’ll need to know what your health plan covers.
Here is a quick review of some coverage basics and tips to keep in mind as you make appointments and discuss treatment plans and options with providers.
Every plan may differ somewhat, but for most health plans:
- Behavioral/mental health care is covered.
- You may owe a percent or set dollar copay per visit plus medicine copays.
- Some medicines may be subject to generic substitution or step therapy. Step therapy means you must try the most basic medicine for the disorder first. If that medicine doesn’t work, then you will be covered for a more expensive medicine. There may be several steps before you, your teen and your teen’s provider decide symptom goals are being met. Keep in mind that medicines can have negative effects. It can take some trial and error to find the medicine that works best.
- Visits might be weekly at first because many psychiatric medications need to be started at a small dose and gradually increased to the dose that is most effective. There can be side effects to jumping right in to a full-strength dose.
- Visits may go to monthly intervals when medicine seems to be working and the situation is more stable.
Whatever the situation, you can call the customer service number on your member ID card when you need information about your coverage or help finding a provider. You can also use the Provider Finder tool.
Last but not least, keep in mind that caregivers and other family members may need support, too. There are often support groups offered by providers or facilities.