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Behavioral Health and Substance Abuse Benefits (Open Enrollment 2020)

Duke offers both outpatient and inpatient behavioral health and substance abuse benefits under each of our medical plans. To find a network provider, call Cigna Behavioral Health toll-free at (888) 253-8552 or visit the Find a Network Provider page.

Cigna Behavioral Health now allows video visits for patients seeing a participating in-network provider. This will require downloading the appropriate software or app used by the provider if this type of service is desired. The co-pay is the same as an in-person visit.

Duke also offers up to eight short-term counseling visits to Duke employees and their immediate family members through the Personal Assistance Service (PAS) at no cost to you. The staff of licensed professionals offer assessment, short-term counseling and referrals to help resolve a range of personal, work and family matters. For information, call (919) 416-1727.

Details about behavioral mental health and substance abuse benefits are outlined below.

  Duke Select (HMO) Duke Basic (HMO) Blue Care
Blue Cross NC (HMO)		 Duke Options
Blue Cross Blue Blue Shield (PPO)
  Cigna Behavioral Health
  In-Network Care Out-of-Network Care
Outpatient
  • Covered in full after $20 co-pay for individual/ family therapy ($25 co-pay for Duke Basic)
  • Precertification required for psychological testing, electroshock therapy, and hypnosis
  • After $650 annual deductible, per visit you pay 30%**
  • Limit of 20 visits per calendar year for Duke Select, Duke Basic, and Blue Care participants (no visit limit applies for Duke Options)
  • Precertification required for psychological testing, electroshock therapy, and hypnosis
Inpatient
  • Co-pay of $600 per admission
  • Must be precertified prior to admission
  • After $900 per admission co-pay and deductible, you pay 30%
  • Limit of 20 days per calendar year for Duke Select, Duke Basic, and Blue Care participants (no day limit applies for Duke Options)
  • Must be precertified prior to admission
  • For Duke Options, the deductible and co-insurance maximum will be consolidated with medical claims

**All payments are based on the allowable charge. You are responsible for charges over the allowable charge when receiving out-of-network services.

Benefits