Covered Mental Health and Substance Use Treatment Services
Mental health and substance use services help AmeriHealth Caritas Louisiana members with:
- Mental illness.
- Substance use.
- Addictive disorders.
- Drug and alcohol use challenges.
Your mental health and substance use benefits and services depend on:
- Your age.
- The type of Medicaid assistance you get.
Your covered services
These services are a part of the AmeriHealth Caritas Louisiana mental health and substance use program.
Addiction services: These services help you deal with challenges due to drug and alcohol use. You might get these services in a hospital. They help you stop using alcohol and/or drugs. If you use these services, you may or may not stay overnight.
Applied behavioral analysis (ABA): Beginning February 1, 2018, members under the age of 21 are eligible for ABA services. The Louisiana Department of Health offers these services for persons who meet the ABA guidelines. Please call your Care Manager at 1-888-643-0005. Your Care Manager can submit a request for prior authorization, which will then be reviewed by AmeriHealth Caritas Louisiana.
Autism spectrum services: Members diagnosed with autism spectrum disorder (ASD) can receive medically necessary covered mental health services. ASD includes:
- Autistic disorder.
- Asperger's disorder.
- Childhood disintegration disorder.
- Rett's disorder.
- Pervasive developmental disorder.
For information, please call Member Services1-888-756-0004, 24 hours a day, 7 days a week.
Community based services:
- Community psychiatric support and treatment (CPST): These are counseling services you get in your home, work, or school.
- Multi-system therapy (MST): This family-based service is for members 12 - 17 years old. It offers home and community services that help you stay in your home. This service focuses on creating a safer and better quality home life for you and your family.
- Family functional therapy (FFT): These services are for members 10 - 18 years old and their families. It focuses on behavioral issues like "acting out." This service is provided in a home or community setting. It helps members change their behaviors.
- Homebuilders (HB): This in-home service is for families with children from birth to 18 years old. The service provides therapy, such as family counseling and parent training. This service focuses on creating a safer and better quality home life for you and your family.
- Assertive community treatment (ACT): This service is for adults with serious mental illness. A team of providers will work with you where you live. Services can include:
- Substance use disorder therapy.
- Housing assistance.
- Medication management.
Crisis intervention/stabilization: You can use this service any time, day or night. It helps you when you are in a mental health or substance use crisis.
If you feel you are in a crisis, call the 24-hour mental health and substance use Crisis Hotline at 1-844-211-0971.
Mental health and substance use services for adults: Members with serious mental illness may be eligible for mental health rehabilitation services such as psychosocial rehabilitation (PSR), assertive community treatment (ACT) and permanent supportive housing (PSH). If you believe you may qualify for these services, talk to your doctor, counselor, and/or care manager. Or, call Member Services at 1-888-756-0004.
Mental health and/or substance use inpatient hospitalization: These services are performed in a hospital. You might be treated in a hospital if:
- You are at risk of harming yourself or others.
- You have a mental health or substance use crisis.
- Your medications need to be watched closely.
- Other services have not helped you.
Mental health outpatient services: These services are planned, regularly scheduled visits to a doctor, counselor, or therapist to talk about your mental health issues. These can include:
- Individual therapy.
- Family therapy.
- Group therapy.
- Psychological and/or neuropsychological testing.
Psychiatric rehabilitation treatment facility (PRTF): This service offers long-term care in a 24-hour group living facility. This is for members younger than 21 years old.
Psychosocial rehabilitation: This service helps you meet your goals and stay in your community with family and friends. You will get help with day-to-day life skills.
Therapeutic group home: This is a community-based, 24-hour live-in service. Members younger than 21 years old would live in a home-like setting with other people to get services.
Parish programs in your area may offer other services and support. We can help you get those services. We can also help find any costs that may apply to you. If we do, we can help you find ways of covering those costs.
With your consent, as needed, we work with other providers to help organize your treatment and support.
You may qualify for these services, but you are not covered for these services through AmeriHealth Caritas Louisiana.
Coordinated system of care (CSoC): We do not cover or manage CSoC services. This special program helps members 21 years old and younger who have serious mental health and substance use issues and are at risk for out-of-home placement. This service also helps their families. Services include:
- Parent support and training.
- Youth support and training.
- Independent living and skills building.
- Short-term respite and wrap around facilitation. Wrap around facilitation means we want you to have one facilitator to coordinate services for all your health care needs.
If you believe you may qualify for these services please contact AmeriHealth Caritas Louisiana Member Services at 1-888-756-0004.
We will ask you a few questions to see if you qualify for these services. If you might, we will give your information to the management company. They will contact you and decide if you qualify for CSoC. If you do not qualify, we can help you to find other services to meet your needs.