All you need to do is choose a behavioral health provider from the MBHP Provider Directory. You can find the directory online at Just a Provider” on the home page. If you would “Find like a printed copy of the Provider Directory, please call MBHP at 1-800-495-0086. After you choose a provider from the directory, please call MBHP to make sure your provider still works with MBHP. This directory is updated weekly, but providers may change from time to time. Although you do not need a referral to see any MBHP provider, some covered services may need PA. For more information about PA, see page 13. Out-of-Network Services Medical services The PCC Plan will not pay for services delivered by a provider who is not a MassHealth provider unless it is an emergency. You can get care for emergencies from any provider. For more information about emergencies, see pages 19-20. If you have an emergency, get care right away! Behavioral health services MBHP will not pay for services provided by a behavioral health provider who is not in the network unless: it is an emergency; or the MBHP network cannot provide those services. You can get care for behavioral health emergencies from any behavioral health provider. For more information about behavioral health emergencies, see pages 19-20. If you have a behavioral health emergency, get care right away! If MBHP’s network cannot provide the services, MBHP will the out-of-network services until the network can provide them. Call MBHP if you have questions out-of-network behavioral health services. When you travel The PCC Plan will pay for you to see an out-of-state provider for medical care only if: you have an emergency; or your health would be at risk if you had to travel home.
All you need to do is choose a behavioral health provider from the MBHP Provider Directory. You can find the directory online at Just “Find a Provider” on the home page. If you would like a printed copy of the Provider Directory, please call MBHP at 1-800-495-0086. After you choose a provider from the directory, please call MBHP to make sure your provider still works with MBHP. This directory is updated weekly, but providers may change from time to time. Although you do not need a referral to see any MBHP provider, some covered services may need PA. For more information about PA, see page 13. Out-of-Network Services Medical services The PCC Plan will not pay for services delivered by a provider who is not a MassHealth provider unless it is an emergency. You can get care for emergencies from any provider. For more information about emergencies, see pages 19-20. If you have an emergency, get care right away! Behavioral health services MBHP will not pay for services provided by a behavioral health provider who is not in the network unless: it is an emergency; or the MBHP network cannot provide those services. You can get care for behavioral health emergencies from any behavioral health provider. For more information about behavioral health emergencies, see pages 19-20. If you have a behavioral health emergency, get care right away! If MBHP’s network cannot provide the services, MBHP will the out-of-network services until the network can provide them. Call MBHP if you have questions out-of-network behavioral health services. When you travel The PCC Plan will pay for you to see an out-of-state provider for medical care only if: you have an emergency; or your health would be at risk if you had to travel home.
mh-pcc-plan-memb-handbook.docx