Mental health benefits, along with substance use disorder benefits, are benefits we provide for items or services to address mental health conditions and substance use disorders. These are described in your Certificate of Coverage and are in accordance with Federal and State law.

We’re committed to providing mental health and substance abuse (MHSA) services to our members. This includes behavioral health treatment, in compliance with the Patient Protection and Affordable Care Act (PPACA), the Mental Health Parity and Addiction Equity Act (MHPAEA), and corresponding regulations. The coverage provided is consistent with recognized independent standards of current medical practice.

Coverage of mental health and substance use disorder benefits are described in your Certificate of Coverage and are in accordance with Federal and State law.

We will not impose deductibles, copayments, coinsurance, and out-of-pocket maximum requirements and limitations upon MHSA treatment services that are more restrictive than the requirements and limitations that apply to all other medical and surgical services.

MHSA services will not be subject to separate cost-sharing requirements. If your plan provides for out-of-network coverage of medical and surgical services, it will also provide out-of-network coverage for MHSA treatment.

If you have concerns regarding your coverage of mental health and substance use disorder benefits, you may to submit inquiries or complaints to the Florida Division of Consumer Services at:

Florida Division of Consumer Services
1.877.693.5236
Out of State: 1.850.413.3089
Website: Behavioral Health Services Overview (myfloridacfo.com)