Behavioral health

Aetna Better Health of California will cover specialized behavioral health services. Services covered differ among members. For more information call Member Services at 1-855-772-9076, TTY 711

If you are thinking about hurting yourself or someone else, or if you have an urgent behavioral health emergency, call 911 or go to the closest hospital. You can use any hospital for emergency care even if it is not in our network. Show your Aetna Better Health of California ID card.

Specialty mental health services apply to services for members with serious mental illnesses. Sacramento or San Diego Behavioral Health County agencies provide these services. It includes both outpatient services and inpatient services. Outpatient services include medication management, therapy, case management, and lab tests.

If you need specialty mental health services, please call Member Services at 1-855-772-9076, TTY 711. Specialty mental health benefits are available to members of any age. And it is provided for on the same basis as any other illness.

We cover outpatient mental health services. You can call Member Services at 1-855-772-9076, TTY 711, or ask your PCP for the name of one of our network mental health providers. These services are for the treatment of mild to moderate mental health conditions, which include:

  • Individual and group mental health testing and treatment (psychotherapy)
  • Psychological testing to evaluate a mental health condition
  • Outpatient services that include lab work, drugs, and supplies
  • Outpatient services to monitor drug therapy
  • Psychiatric consultation

You can also get specialty mental health services from Sacramento or San Diego County Behavioral Health Services.

We cover these substance use disorder services:

  • Outpatient substance use disorder services, including residential treatment services
  • Voluntary inpatient detoxification

Behavioral Health Treatment (BHT) services are a covered benefit with a confirmed diagnosis of Autism Spectrum Disorder (ASD). Covered BHT services are evidence-based treatments that develop or restore, to the maximum extent practicable, the functioning of an individual with autism spectrum disorder (ASD).

BHT services teach skills through the use of behavioral observation and reinforcement, or through prompting to teach each step of a targeted behavior. BHT services are based on reliable evidence and are not experimental. Examples of BHT services include behavioral interventions, cognitive behavioral intervention package, comprehensive behavioral treatment, language training, modeling, natural teaching strategies, parent/guardian training, peer training package, pivotal response training, schedules, scripting, self-management, social skills package, and story-based intervention.

BHT services must be medically necessary, prescribed by a licensed doctor or psychologist, approved by the plan, and provided in a way that follows the approved treatment plan.

You may qualify for BHT services if:

  • You are under 21 years of age.
  • Have a diagnosis of ASD.
  • Have behaviors that interfere with home or community life. Some examples include anger, violence, self-injury, running away, or difficulty with living skills, play and/or communication skills.

You do not qualify for BHT services if you:

  • Are not medically stable.
  • Need 24-hour medical or nursing services.
  • Have an intellectual disability (ICF/ID) and need procedures done in a hospital or an intermediate care facility.