Therapy that takes Carelon Behavioral Health in Wisconsin

Why this name appears when your card says something else

Many health plans do not administer mental health benefits themselves. They contract the work out, and Carelon is one of the companies that does it. So your medical coverage sits with one organisation while authorising and paying for therapy sits with another.

You might arrive here from an Anthem plan, an employer plan, or a state programme. The medical card in your wallet can say almost anything; what matters for therapy is who manages the behavioral health side.

How to tell whether this applies to you

Turn your insurance card over. If there is a separate line for behavioral health or mental health, that is your route, and the company answering it may not be the one named on the front.

If you have already called the main member services number and been told they cannot see a mental health benefit, this is almost certainly why. You were not refused; you reached the wrong department.

You may know it by an older name

This company has been rebranded relatively recently, and a good deal of paperwork, directory listing and employer benefit documentation still carries the previous one. If you are looking at a booklet that names a company you cannot find anywhere, that is very likely why.

If you are unsure whether the name on your documents and the name on your benefit are the same organisation, ask. It is a common enough confusion that member services will know immediately what you mean.

What I’d ask them

• What is my cost for outpatient psychotherapy with a Licensed Professional Counselor?
• Does my medical deductible apply to mental health visits, or is it separate?
• Is telehealth covered at the same rate as in-person?
• Do I need authorisation before starting, or only after a certain number of sessions?