Premera Mental Health Coverage: What You Need to Know

Mental health care is essential for overall well-being, and having the right insurance coverage can make accessing care more affordable and convenient. If you have Premera Blue Cross insurance, you may be wondering what mental health services are covered and how to use your benefits effectively.

Premera provides coverage for various mental health treatments, including therapy, counseling, and Partial Hospitalization Programs (PHP). However, coverage specifics vary by plan, and understanding the details can help you maximize your benefits while minimizing out-of-pocket costs.

At The Center • A Place of HOPE, we work with Premera Blue Cross to provide comprehensive mental health treatment, ensuring you receive the care you need.

Does Premera Cover Mental Health Treatment?

Yes, Premera Blue Cross covers mental health services, but the extent of coverage depends on your specific plan. Under the Mental Health Parity and Addiction Equity Act (MHPAEA), most Premera plans must offer mental health benefits equal to physical health benefits^[1].

Mental Health Services Typically Covered by Premera:

• Individual Therapy – Sessions with a licensed therapist for anxiety, depression, PTSD, and more.
• Group Therapy – Support groups and structured therapy sessions led by mental health professionals.
• Family and Couples Therapy – Counseling services designed to support relationship and family dynamics.
• Medication Management – Coverage for psychiatric evaluations and prescriptions for mental health medications.
• Intensive Outpatient Programs (IOP) – Structured mental health treatment for individuals needing more support than traditional therapy.
• Partial Hospitalization Programs (PHP) – Comprehensive, structured treatment that offers an alternative to inpatient care.

What Mental Health Conditions Does Premera Cover?

Premera’s mental health coverage extends to a variety of conditions, including:

✅ Depression and anxiety disorders
✅ Post-Traumatic Stress Disorder (PTSD)
✅ Obsessive-Compulsive Disorder (OCD)
✅ Eating disorders
✅ Bipolar disorder
✅ Substance use disorders
✅ ADHD and other behavioral health conditions

Coverage may require pre-authorization or referrals, depending on your plan.

Premera’s Network: In-Network vs. Out-of-Network Coverage

When choosing a mental health provider, understanding the difference between in-network and out-of-network coverage is crucial.

• In-Network Providers – Mental health professionals with a contract with Premera offer lower copays and coinsurance rates.
• Out-of-Network Providers – Providers who are not contracted with Premera may still offer coverage but at a higher out-of-pocket cost.

At The Center • A Place of HOPE, we are in-network with Premera, making it easier for you to receive high-quality, affordable mental health treatment.

Does Premera Cover Partial Hospitalization Programs (PHP)?

Yes, Premera Blue Cross covers Partial Hospitalization Programs (PHP) for individuals requiring structured mental health treatment without full hospitalization.

What to Expect from a PHP Program

A PHP program provides:
✔️ Structured therapy sessions throughout the day
✔️ Access to licensed mental health professionals
✔️ A supportive, recovery-focused environment
✔️ A combination of individual, group, and holistic therapies

The Center • A Place of HOPE specializes in PHP treatment for mental health, offering a whole-person approach to recovery.

How to Check Your Premera Mental Health Coverage

To determine what mental health services are covered under your specific Premera plan, follow these steps:

1 – Log in to Your Premera Member Account
Visit the Premera website and log in to your account to check your benefits.

2 – Call Premera Customer Service
Speak with a representative to confirm copays, deductibles, and covered services.

3 – Contact Your Employer’s HR Department
If you have employer-sponsored Premera coverage, they can provide details on the benefits.

4 – Speak with a Mental Health Provider
Contact The Center • A Place of HOPE at (888) 851-7031 to verify your insurance benefits.

Does Premera Require Pre-Authorization for Therapy or Treatment?

Some Premera plans require pre-authorization before covering mental health services. This means you may need:

• A referral from a primary care provider (PCP).
• A diagnosis from a licensed professional to prove medical necessity.
• A pre-approval request for intensive treatment programs like PHP or IOP.

Our admissions team at The Center • A Place of HOPE can streamline the process by assisting you with pre-authorization and insurance verification.

Out-of-Pocket Costs: What You Need to Know

Your costs depend on several factors, including your deductible, copay, and coinsurance. Here’s how these terms affect your mental health expenses:

• Deductible – The amount you pay before insurance starts covering costs.
• Copay – A fixed amount you pay per session (e.g., $20–$50 for therapy).
• Coinsurance – A percentage you pay after meeting your deductible (e.g., 20% of total costs).

💡 Tip: Choosing an in-network provider like The Center • A Place of HOPE reduces your out-of-pocket expenses.

How to Use Your Premera Insurance for Mental Health Treatment

If you’re ready to begin mental health treatment with Premera coverage, follow these steps:

1. Find an In-Network Provider
Use Premera’s provider directory or call The Center • A Place of HOPE for insurance verification.

2. Confirm Your Coverage
Check your copay, deductible, and session limits before starting treatment.

3. Schedule an Initial Assessment
Our admissions team will assess your needs and recommend personalized treatment options.

4. Begin Treatment at The Center • A Place of HOPE
Receive evidence-based, whole-person mental health treatment tailored to your condition.

Frequently Asked Questions (FAQs) About Premera Mental Health Coverage

Does Premera cover therapy for anxiety and depression?

Yes, Premera provides coverage for therapy, counseling, and psychiatric care for anxiety and depression. Coverage varies by plan.

Can I use Premera for Partial Hospitalization Programs (PHP)?

Yes, many Premera plans cover PHP as an alternative to inpatient care. Check with your provider for details.

Do I need a referral to use my Premera mental health benefits?

Some plans require a referral or pre-authorization before covering therapy or structured treatment programs.

Does Premera cover medication for mental health conditions?

Yes, Premera offers coverage for psychiatric medications, but copays and formularies vary by plan.

What if my therapy claim is denied?

You can appeal a denied claim by contacting Premera member services or working with your provider to submit the necessary documentation.

Start Your Mental Health Journey Today

If you’re covered by Premera Blue Cross, you may have access to comprehensive mental health treatment at The Center • A Place of HOPE. Our in-network PHP and therapy programs provide evidence-based care for depression, anxiety, trauma, and more.

📞 Call us at (888) 851-7031 to verify your Premera coverage and start your healing journey today.

1 – Mental Health Parity and Addiction Equity Act (MHPAEA) – U.S. Department of Labor
🔗 https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/mental-health-and-substance-use-disorder-parity
2 – Premera Mental Health Coverage – Premera Blue Cross
🔗 https://www.premera.com/sites/aag/care-essentials/mental-health