DISABILITY 26 HEALTH AND WELLNESS Plan Feature Scripps HMO Option Scripps EPO Option Mental Health/Chemical Dependency* • Who Directs and Provides Care • Outpatient Visit • Inpatient Carelon Behavioral Health $25 copay (Network only) $300 copay per admission Anthem Blue Cross behavioral health providers $30 copay (Network only) $300 copay per admission * Refer to Scripps Medical Plan Summary Plan Documents at MyScrippsHealthPlan.com for information on pre-service review requirements. Mental Health/Chemical Dependency Benefits If you are enrolled in the HMO option, effective April 1, 2026 mental health and chemical dependency benefits will transition from Magellan to the Carelon Behavioral Health network, as Magellan is discontinuing operations in California. Benefits will continue to be managed by Magellan through March 31, 2026. Your behavioral health provider may or may not participate with Carelon Behavioral Health Network. Efforts are underway to offer Carelon Behavioral Health network participation to all providers who are actively treating Scripps Health Plan members. Network participation is contingent on the provider successfully completing the contracting and credentialing process with Carelon Behavioral Health. If your provider chooses not to participate in the Carelon Behavioral Health network, you may still qualify for Continuity of Care access to your provider for up to 12 months. You can find a current list of Carelon Behavioral providers at MyScrippsHealthPlan.com. If you have any questions about these changes, the Carelon Behavioral Health provider network or the Continuity of Care process, please contact Scripps Health Plan Customer Service at 844-337-3700. All treatment must be provided by a Carelon Behavioral Health provider starting April 1, 2026 (except in case of emergency or if a specialty you require is not available in the network). A referral from your primary care physician is not required. If you need care and are enrolled in the HMO option, contact Scripps Health Plan Customer Service at 844-337-3700. If you are enrolled in the EPO option, mental health and chemical dependency benefits are administered through the Anthem Blue Cross network of behavioral health providers. All treatment must be provided by an Anthem Blue Cross behavioral health provider (except in case of emergency or if a specialty you require is not available in the network). If you need care and are enrolled in the EPO option, contact Personify Health Member Services at 877-552-7247. You will talk to a representative who will refer you for the appropriate care and notify you if pre-authorization is required. The type and/or extent of treatment will be determined based on clinical assessment.
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