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NYSHIP Empire Plan for Mental Health Therapy Treatment

“What does NYSHIP cover for mental health?” We answer that and more on the nuances of mental health treatment with your NYSHIP Empire Plan—access details about behavioral health coverage, mental health benefits, and the process of accessing services. Gain a deeper understanding of the available options for seeking therapeutic support to enhance your psychological health and emotional well-being.

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What is the NYSHIP Empire Plan?

The NYSHIP Empire Plan is a flagship component of the New York State Health Insurance Program (NYSHIP), offering comprehensive health coverage to public employees, retirees, and their families. Administered by the New York State Department of Civil Service, the Empire Plan provides a wide range of healthcare benefits, including medical, hospital, mental health, prescription drug, and dental coverage.

The NYSHIP Empire Plan participants benefit from a large selection of in-network providers, both in-state and nationwide, allowing for flexibility and choice in seeking medical and psychiatric care coverage. As a cornerstone of the New York State Health Insurance Program (NYSHIP), the Empire Plan reflects the state’s dedication to providing reliable, comprehensive health insurance options to its public workforce, contributing to the overall health and stability of individuals and families throughout New York State.

New York and Mental Health Statistics

New York and Mental Health Statistics

Annually, the mental health landscape in New York reveals that over 20% of its residents exhibit symptoms of a mental health disorder. A noteworthy 10% of both adults and children in the state face mental health challenges impactful enough to disrupt their functioning in work, family, and school environments.

Alarmingly, there is an evident racial disparity, with Black, Latinx, Asian American, and Pacific Islander residents of New York less likely to be connected to mental healthcare compared to their White counterparts. The shortage of mental health professionals is also a pressing issue, with 4,102,718 individuals residing in communities lacking sufficient mental health resources. Further concerning is the lasting impact of the COVID-19 pandemic on mental health, with rates of depression and anxiety remaining significantly elevated.

Exploring the Empire State and its Famous Cities

Exploring the Empire State and its Famous Cities

Embark on a captivating journey through the Empire State, a land of diverse landscapes and vibrant cities. At the heart of it all is the iconic New York City, a global metropolis renowned for its towering skyscrapers, iconic landmarks like Times Square and Central Park, and a cultural melting pot that gives the city its unique energy.

Venturing westward, Buffalo sits on the shores of Lake Erie, celebrated for its rich industrial history and the majestic Niagara Falls nearby. Albany, the state capital, showcases a blend of historic charm and modern governance, with the impressive New York State Capitol building dominating the skyline. To the north, Rochester, a city with a legacy in innovation and technology, is home to renowned institutions like the Eastman School of Music. Syracuse, known for its academic prowess, hosts Syracuse University and boasts a lively arts scene. Lastly, Yonkers, just north of New York City, charms with its suburban appeal and the picturesque Hudson River waterfront.

>What is the NYSHIP Empire Plan?

What is NYSHIP Rehab Insurance Coverage?

NYSHIP, or the New York State Health Insurance Program, provides coverage for rehabilitation services through its various health plans. Rehabilitation insurance coverage typically includes services aimed at helping individuals recover or manage conditions related to physical and mental health disorders, including substance use. The coverage specifics may vary depending on your particular health plan with NYSHIP.

Call 877-958-9212 to access the details of your NYSHIP rehabilitation insurance coverage. Our helpful patient advocates can provide information on potential out-of-pocket expenses, such as copayments for therapy, the rehab admission process, and more.

Does NYSHIP Empire Plan Cover Mental Health Therapy Treatment?

Yes, NYSHIP provides coverage for mental health therapy treatment. This includes a range of mental health benefits, such as coverage for psychotherapy and counseling services. The coverage extends to various therapeutic interventions, ensuring you and your loved ones receive the necessary assistance for optimal wellness and mental health.

NYSHIP recognizes the significance of mental health awareness. You can benefit from a network of qualified mental health professionals, and the coverage often includes both inpatient and outpatient services.1 Review your specific NYSHIP health plan by calling 877-958-9212. It’s important to understand the details of your mental health insurance coverage, including any mental health coverage limitations.

Does Allegiance Cover Therapy for Mental Health Treatment?

Allegiance’s commitment to mental health awareness is evident in its coverage of mental health therapy treatment as a part of its broader services promoting psychological health. They recognize the importance of addressing mental health concerns and provide coverage for various therapy options, including individual, group, and family therapy, as well as counseling and psychiatric services.

The extent of coverage may vary depending on your specific plan and additional factors, so it’s essential to review your policy and consult with Allegiance to understand the details of your benefits and how to access the mental health support you need. Call 877-958-9212 to verify insurance coverage details for mental health treatment.

Rehabs in Florida That Accept NYSHIP Empire Plan

The Sylvia Brafman Mental Health Center in South Florida is a rehabilitation facility that may accept your NYSHIP Empire Plan to assist with your mental health treatment expenses. Our skilled medical and clinical team is committed to accurate diagnoses, implementing effective treatment strategies, mental health advocacy, and providing support to overcome challenges.

For additional information about our services, programs, the admissions process, and more, please dial 877-958-9212. A compassionate patient advocate is ready to guide you through the next steps toward recovery. You are also welcome to visit our physical location at the address provided below:

>Rehabs in Florida That Accept NYSHIP Empire Plan

New York State Health Insurance Program Covers the Following

The New York State Health Insurance Program (NYSHIP) delivers comprehensive health coverage to public employees and their dependents. Encompassing medical, hospital, mental health, prescription drug, and dental services, NYSHIP ensures a well-rounded approach to healthcare. This coverage extends to various mental health treatment programs, offering flexibility and choice.

Below, we’ll delve into specific aspects of NYSHIP coverage, thoroughly exploring the diverse healthcare services available.

NYSHIP Empire Plan for Partial Hospitalization Programs

NYSHIP Empire Plan for Partial Hospitalization Programs

A Partial Hospitalization Programs (PHP) offer a more intensive level of support than traditional outpatient services, making them suitable for individuals who require focused treatment but don’t need 24-hour inpatient care. These intensive day programs provide comprehensive therapy and mental health support. PHPs usually include therapeutic activities, counseling sessions, medication management, and skill-building exercises throughout the day.

Under the NYSHIP Empire Plan, coverage for partial hospitalization programs for mental health and substance abuse treatment is often included as part of its benefits. These services require preauthorization for mental health services and must be deemed medically necessary to benefit from NYSHIP’s psychiatric care coverage.

NYSHIP Empire Plan for Intensive Outpatient Programs

NYSHIP Empire Plan for Intensive Outpatient Programs

An Intensive Outpatient Program (IOP) is designed to provide a structured, comprehensive level of care. Unlike inpatient programs, participants in IOPs receive therapeutic interventions, counseling, and mental health resources during scheduled sessions while maintaining the flexibility to reside at home. This approach allows individuals to continue with daily life responsibilities while benefiting from heightened mental health support.

NYSHIP Empire Plan typically covers medically necessary intensive outpatient programs within their plans. This type of mental health treatment will require preauthorization, as well.

NYSHIP Empire Plan for Outpatient Programs

NYSHIP Empire Plan for Outpatient Programs

The NYSHIP Empire Plan includes coverage for outpatient programs, offering crucial mental health services without requiring individuals to reside in a treatment facility. These structured programs provide flexibility for participants to maintain their daily routines while receiving counseling and other therapeutic interventions during scheduled sessions.

NYSHIP’s commitment to comprehensive mental health services ensures that participants can access a diverse range of treatment options, with specific coverage details in the policy documentation, including any associated limitations or copayments for therapy sessions. You can also check your insurance coverage details for outpatient mental health services online or by calling 877-958-9212.

NYSHIP Empire Plan for Residential Inpatient Treatment

NYSHIP Empire Plan for Residential Inpatient Treatment

NYSHIP Empire Plan typically covers medically necessary residential inpatient treatment, an intensive mental health program situated in a structured residential environment. Residential treatment employs a range of therapeutic interventions, including counseling, group therapy coverage, and skill-building exercises, to provide comprehensive support for individuals facing severe mental health challenges.

Policy details will vary, including mental health copayments, limitations, and preauthorization. Review your policy documentation or reach out to The Sylvia Brafman Mental Health Center at 877-958-9212 for assistance.

>New York State Health Insurance Program Covers the Following

What Types of Mental Health Disorders Does NYSHIP Cover?

Administered by Carelon Behavioral Health, NYSHIP’s mental health & substance use programs include coverage for inpatient and outpatient mental health and substance abuse treatments and services. The examples below offer insights into the diverse range of psychiatric conditions The New York State Health Insurance Program addresses, encompassing various therapeutic interventions tailored to the specific needs of those seeking care.

As always, reviewing your particular plan is essential, and you can do so by calling 877-958-9212. One of our patient advocates will be available to walk you through the details tailored to your or your loved one’s specific mental health treatment needs and preferences. In addition, we can schedule a complimentary mental health assessment for your convenience. Keep in mind that the below is a short list of examples and is not a complete list of the broad range of mental health conditions covered by the NYSHIP Empire Plan.

Treatment for Bipolar Disorder and Cyclothymia

Treatment for Bipolar Disorder and Cyclothymia

Individuals diagnosed with bipolar disorder and cyclothymia, two related mood disorders, often require specialized treatment to manage symptoms effectively. Bipolar disorder is characterized by extreme mood swings, including manic episodes with elevated energy and depressive episodes marked by profound sadness. Cyclothymia involves chronic mood fluctuations but with less severe highs and lows compared to bipolar disorder.

Treatment for these conditions typically involves a combination of mood-stabilizing mental health medications, psychotherapy techniques, and lifestyle adjustments to maintain stability and manage the impact on day-to-day life. The NYSHIP Empire Plan typically provides coverage for a range of treatments for these mood disorders.

Treatment for Borderline Personality Disorder (BPD)

Treatment for Borderline Personality Disorder (BPD)

Enduring patterns of instability in interpersonal relationships, self-image, and emotions characterize Borderline Personality Disorder (BPD). Intense, unpredictable mood swings, difficulty forming and maintaining stable relationships, and engaging in impulsive, self-destructive behaviors are often signs. Managing BPD involves a combination of psychotherapy, including dialectical behavior therapy (DBT), as well as medication to address specific symptoms or co-occurring conditions.

The NYSHIP Empire Plan often covers BPD treatment, including psychotherapeutic interventions for developing coping strategies and self-care practices, as well as medication management.

Treatment for Anxiety Disorder

Treatment for Anxiety Disorder

Anxiety disorders comprise a cluster of mental health conditions marked by an abundance of persistent concern, fear, or unease that substantially disrupts everyday functioning. These disorders may manifest in various forms, including generalized anxiety disorder and specific phobias. Symptoms such as restlessness, muscle tension, irritability, and difficulty concentrating are often prevalent.

Effective anxiety treatment generally involves psychotherapy, such as cognitive-behavioral therapy (CBT) or exposure and response therapy (ERP), as well as mental health medications, particularly in cases with severe symptoms. The NYSHIP Empire Plan typically covers a range of evidence-based anxiety treatments. This coverage often includes therapeutic interventions aimed at addressing the anxiety’s root causes and developing coping strategies. Medication management, such as prescription medications for anxiety, may also be covered.

Treatment for Major Depressive Disorder (MDD)

Treatment for Major Depressive Disorder (MDD)

Major Depressive Disorder (MDD), commonly known as depression, is a prevalent mental health condition involving persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in daily activities. Depression symptoms may present as changes in appetite, sleep disturbances, fatigue, and difficulty concentrating. They can significantly impact a person’s life, leading to relationships, work, and overall well-being challenges.

Effective treatment for MDD often involves a combination of psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy, and medication, such as antidepressants. The NYSHIP Empire Plan typically provides comprehensive coverage for evidence-based depression treatments, including medication management and psychotherapy techniques aimed at improving cognitive function and emotional well-being.

Treatment for Post-Traumatic Stress Disorder (PTSD)

Treatment for Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) can develop after experiencing or witnessing a traumatic event. Symptoms involve re-experiencing the trauma through intrusive memories, nightmares, or flashbacks, leading to intense emotional and psychological distress. Other symptoms may include avoidance of reminders of the trauma, heightened arousal, and negative changes in mood and cognition.

The NYSHIP Empire Plan typically covers evidence-based PTSD treatments, like psychotherapy, such as eye movement desensitization and reprocessing (EMDR), as well as medication, particularly for stress management and associated symptoms like anxiety or insomnia.


>What Types of Mental Health Disorders Does NYSHIP Cover?

Does NYSHIP Cover Dual Diagnosis Treatment?

The NYSHIP Empire Plan typically covers dual diagnosis treatment, which addresses mental health and substance use disorders simultaneously. This holistic strategy recognizes the intricate interconnection between mental health and substance-related concerns, providing thorough assistance for individuals managing co-occurring conditions.

Dual diagnosis treatment often includes a range of services, such as psychotherapy, medication management, and substance use counseling. This holistic approach addresses both aspects of the comorbid conditions, promoting long-term recovery and overall well-being. For tailored details on dual diagnosis treatment under your particular NYSHIP policy, call 877-958-9212.

How Much Does Rehab Cost with NYSHIP Insurance?

The average cost for an individual in outpatient rehabilitation in Florida is approximately $1,705.2 However, this number is subject to significant variation. Your specific plan, in-network or out-of-network coverage, and the type and duration of treatment all influence rehabilitation costs.

For an accurate estimate of your rehab expenses and answers to the common question, “How much does NYSHIP cover for therapy?” call 877-958-9212. We can explain how your coverage applies to your specific treatment needs.

How To Check My NYSHIP Empire Plan Coverage Levels

The most efficient and easy way of checking your NYSHIP Empire Plan coverage levels is to call 877-958-9212. Our dedicated team at The Sylvia Brafman Mental Health Center is ready to engage with your health insurance provider to clarify coverage details.

Following this, we’ll guide you through the particulars of your policy, providing comprehensive insights into available treatment options, program choices, and any associated out-of-pocket expenses. This ensures that you are well informed and equipped to make decisions regarding your mental health treatment.

How Many Times Will NYSHIP Pay for Rehab?

The number of times NYSHIP will pay for rehab depends on individual circumstances, coverage limits, and the specific terms of the health plan. NYSHIP typically covers multiple rounds of rehabilitation if medically necessary, but details vary. Refer to your policy documentation or call 877-958-9212 to clearly understand any limitations or conditions associated with multiple treatment episodes.

Mental Health Statistics in New York

Mental Health Statistics in New York

  • Annually, over 20% of New Yorkers exhibit symptoms of a mental health disorder.3
  • Each year, 10% of adults and children in New York encounter mental health challenges significant enough to impact their functioning in work, family, and school environments.
  • Black, Latinx, Asian American, and Pacific Islander residents of New York are less likely to be linked to mental healthcare compared to their White counterparts.4
  • In New York, 2,802,000 adults are affected by a mental health condition, a number exceeding the population of Buffalo by more than ten times.5
  • In New York, 4,102,718 individuals reside in a community lacking sufficient mental health professionals.
  • Among the 91,271 homeless individuals in New York, one in six struggles with a serious mental illness.
  • 70% of youth in the juvenile justice system in New York have a mental health condition.
  • Out of New Yorkers aged 12–17 dealing with depression, 56.8% did not receive any care in the past year.
  • Over three years since the start of the COVID-19 pandemic, depression and anxiety rates among New Yorkers continue to be significantly elevated. One in three New Yorkers still grapple with one or both conditions, a rate that has remained unchanged since May 2021.6
  • Poor mental health is observed in over half (57.4%) of food-insufficient New Yorkers, which is nearly twice the rate found among those who are food-sufficient (29.2%).

Sources:

  1. “At a Glance.” New York State Department of Civil Service Employee Benefits Division, Jan. 2024, www.cs.ny.gov/employee-benefits/pa-market/shared/publications/at-a-glance/2024/paep-aag-jan-2024.pdf.
  2. Stilkind, Joseph. “Average Cost of Drug Rehab [2023]: By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab.
  3. “Priority Area: Mental Health/Substance Abuse – Mental Health.” New York State Department of Health, Apr. 2022, www.health.ny.gov/prevention/prevention_agenda/mental_health_and_substance_abuse/mental_health.htm.
  4. “Mental Health Data Dashboard.” Mayor’s Office of Community Mental Health, mentalhealth.cityofnewyork.us/dashboard. Accessed 12 Dec. 2023.
  5. “Mental Health in New York.” National Alliance on Mental Illness (NAMI), Feb. 2021, www.nami.org/NAMI/media/NAMI-Media/StateFactSheets/NewYorkStateFactSheet.pdf.
  6. “Mental Health of New Yorkers Stagnates Overall, Worsens for Some New Yorkers – New York Health Foundation.” New York Health Foundation, 21 June 2023, nyhealthfoundation.org/2023/06/21/mental-health-of-new-yorkers-stagnates-overall-worsens-for-some-new-yorkers.

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