The Harvard University Group Health Plan behavioral health benefit is managed by Blue Cross Blue Shield of Massachusetts. For in-network care, members with the HMO, POS, and POS Plus plans can select a behavioral health provider in the HMO Blue network and members with the HDHP plan can select a behavioral health provider in the PPO network.
- You do not need a referral from your primary care physician for these services
- The first 12 visits in a calendar year do not require Blue Cross Blue Shield review and approval
- After the first 12 visits, your provider will submit authorization to Blue Cross Blue Shield and additional visits will be approved based on medical necessity
- Neuropsychological testing will require prior authorization for all members (HMO, POS, POS Plus, and HDHP)
POS, POS Plus, and HDHP Members
Harvard University Group Health Plan POS, POS Plus, and HDHP members can select an out-of-network behavioral health provider—this will result in higher out-of-pocket costs. Blue Cross Blue Shield of Massachusetts calculates payment of your benefits based on the allowed amount, not the actual charge. If your health care provider charges more than the allowed amount, you may have to pay the difference. Review your Benefit Description for more details.