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Behavioral Health and Substance Abuse Benefits

Personal Assistance Service

Duke 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.

Applied Behavior Analysis for Treatment of Autism Spectrum Disorder

Children of Duke employees covered under a Duke medical plan (Duke Select, Duke Basic, Blue Care, Duke Options, or Duke USA) may seek treatment for Autism Spectrum Disorder with Applied Behavior Analysis.

Duke's coverage for outpatient and inpatient behavioral health and substance abuse benefits is provided through our regular medical vendors. If you enroll in Duke Select or Duke Basic, your behavioral health and substance abuse benefits are provided by Aetna. If you enroll in Blue Care, Duke Options, or Duke USA, your behavioral health and substance abuse benefits are provided by Blue Cross Blue Shield.

You are able to access behavioral health care through your medical ID card and have a single insurance provider to deliver a comprehensive approach to treating your physical, mental and emotional needs. Your medical and behavioral health providers are able to work together to identify the best care for you. Both Aetna and Blue Cross Blue Shield offer a suite of online tools that work in conjunction with their medical platforms to maximize the support you need.

For questions related to your behavioral health benefits, please contact Aetna Behavioral Health at 800-424-4047 and Blue Cross Blue Shield's Behavioral Health Line at 800-359-2422. Representatives will be happy to assist you with your needs.

Duke also offers up to eight 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, referrals and a range of other services to assist with personal, work and family matters. For information, call (919) 416-1727.

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

  In-Network Care Out-of-Network Care
Outpatient
  • Precertification required for psychological testing, electroshock therapy, and transcranial magnetic stimulation (TMS)
  • Covered in full after $20 co-pay for individual/ family therapy ($25 co-pay for Duke Basic/Duke USA)
  • Precertification required for psychological testing, electroshock therapy, and transcranial magnetic stimulation (TMS)
  • After $650 annual deductible, you pay 30%* (you pay 40% on Duke USA)
  • Limit of 20 visits per calendar year for Duke Select, Duke Basic, and Blue Care participants (no visit limit applies for Duke Options or Duke USA)
Inpatient
  • Must be precertified prior to admission
  • Co-pay of $600 per admission
  • Must be precertified prior to admission
  • After $900 per admission co-pay and deductible, you pay 30% (you pay 40% on Duke USA)
  • Limit of 20 days per calendar year for Duke Select, Duke Basic, and Blue Care participants (no day limit applies for Duke Options or Duke USA)
  • 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