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Recently Suffolk County EMHP switched to Optum for the management of Mental Health and Substance Abuse Disorders for members of the Employee Medical Health Plan of Suffolk County (EMHP). In an effort to ensure a smooth transition to this new Mental Health and Substance Abuse Disorder Administrator, we would like to pass along a helpful FAQ issued to County Employees. A selection of the Frequently Asked Questions can be found below. The FAQ can be viewed in full here.
Will I receive a new I.D. Card? Yes, a new Employee Medical Health Plan ID Card will be issued in January with the Optum contact information on the back of the ID Card.
What do I need to do if I or one of my eligible dependents is in an inpatient, residential, partial, or IOP treatment program on February 1, 2023? If you or your eligible dependents are currently receiving any MH/SUD treatment higher than standard outpatient treatment (inpatient, residential, partial hospitalization, or IOP) on February 1, 2023, your provider needs to call Optum on February 1, 2023, to obtain new authorizations. Any authorizations issued by Beacon for dates of service on or after February 1, 2023, are not valid.
How do I find out if my provider is in the Optum Behavioral Health network? To find out if your provider is in the network, you can access the provider directory online by logging into the Optum website @ www.LiveAndWorkWel1.com and using the access code “Suffolk”. You can also call Optum at 800-765-6709 on or after February 1, 2023 for assistance.
What action do I need to take if my outpatient provider is in the Optum Behavioral Health network? You should alert your provider that your insurance coverage has changed and will be administered by Optum as of February 1, 2023, and your treatment will continue as normal. Just give your provider a copy of your new benefits card.
What action do I need to take if my outpatient provider is not in the Optum Behavioral Health network?
• If your provider is not contracted with Optum Behavioral Health, and your care continues beyond February 1, 2023, you must call to access your transition of care benefit. You will be allowed to stay with your current licensed provider until April 30, 2023, if your treatment began prior to February 1, 2023. During this period, your claims will be paid at the in-network benefit level. Your cost will be limited to your in-network coverage; this is called your “transition of care” benefit.
• Call Optum Behavioral Health at 800-765-6709 to request Behavioral “transition of care” benefits. You will speak with a representative who will request specific information about your care. Participants should call as soon as possible on or after February 1, 2023, to avoid claims issues.
• Once Optum Behavioral Health is notified that you want to use your “transition of care” benefits, your record will be updated so that you may continue to be treated by your licensed non-contracted provider through April 30, 2023.
What happens if I do not transition my benefits? If you do not request “transition of care” benefits, your outpatient therapy visits will be paid using the out-of-network benefit level starting February 1, 2023. As a Reminder, the FAQ can be viewed in full here.
Please note, services with Optum begin on February 1, 2023. For any services needed prior to February 1, 2023, please continue to contact Beacon Health Options at 1-866-909-6472.
If you have any questions about your Behavioral Health Benefits, please call Optum on or after February 1, 2023, at 800-765-6709.