Does CHOP Take My Mental Health Insurance?

The Department of Child & Adolescent Psychiatry and Behavioral Science (DCAPBS) at The Children's Hospital of Philadelphia has agreements with the list of insurance plans provided in the alphabetical list on this page. Each of these agreements is different, and coverage varies depending on services provided by DCAPBS.

This list of participating insurance plans is split into two categories:

  • Plans that cover a medical diagnosis. A medical diagnosis requiring care from a mental health professional is one where there is either an emotional or behavioral response to a medical diagnosis that interferes with the child's medical care, or there is a behavioral problem that led to the medical problem. Example: A child is diagnosed with cancer and must have chemotherapy. But a fear of needles keeps him from his treatment. This requires care from mental health professional who will help him overcome his fear. Example: A child with Crohn’s disease experiences a disease flare and is hospitalized, unable to attend school, spend time with friends or participate in after school activities. The mental health professional can help the child learn ways to manage her pain, to help relieve her anxiety related to resuming her normal activities.
  • Plans that cover a mental health diagnosis. A mental health diagnosis is one where the primary issue that led the family to bring their child in for care is behavioral, not physical. Examples include: autism, attention deficit disorder, anxiety and depression.  

If you are not sure if the healthcare services provided to your child will be covered by your insurance plan, please contact your insurance provider to find out what is covered or call our Pre-Visit Financial Counseling Hotline at 1-800-664-7855 for additional information.

Please know that plans may be added or deleted at times, and that health plan acceptance may vary by provider. If you don't see your plan here or you want to check participation status, please call your insurance company to find out whether or not it considers CHOP and its providers to be in-network. CHOP and its affiliated providers work with many health insurance plans located outside of the Philadelphia area, including Medical Assistance Plans, to arrange for coverage on an individual basis.

Insurance plans participating with CHOP Behavioral Health

Medical Diagnosis

A | BC | D | E | H | I | K | L | M | N | O | P | Q | T | U | V |

A

  • Aetna* (CHOP Preferred, CDHP, Elect Choice, POS, HMO, PPO, Managed Choice, Traditional Choice, US Access, Chickering Group, Signature Administrators) *when behavioral health is managed by Aetna Behavioral Health
  • Aetna Better Health Kids (CHIP) *when behavioral health is managed by Aetna Behavioral Health
  • Aetna Better Health *certain codes require authorization
  • AmeriHealth (NJ: EPO, HMO, POS, PPO; PA: EPO, HMO, POS, PPO; DE: HMO, POS, PPO)
  • Amerihealth 65
  • Amerihealth Administrators (PPO)
  • AmeriHealth Caritas* (PA Medicaid) *authorization required; our contract does not apply to any NJ site

B

  • Blue Cross Blue Shield of California — Crozer Keystone Health System Plan only

C

  • Cigna Health Plans* (HMO, PPO)
  • Coventry Transplant *authorization required
  • Crozer Keystone Health System Plan — Blue Shield of California

D

  • Devon Health Services *benefits vary by client

E

  • Employers Health Network *authorization required

G

  • Geisinger Health Plans, except St. Luke’s Hospital Priority Care Plus Plan
  • Golden Rule Insurance Plan *when managed by UBH

H

  • HealthAmerica
  • HealthNet Federal Services (TRICARE West)
  • HealthPartners of Minnesota* (commercial plan)
  • H.E.R.E.I.U. Welfare Fund
  • Highmark Blue Shield, indemnity programs
  • Highmark Health Options (DE Medicaid)
  • Highmark Premier Blue (CHCA, CSA, RACH, CAA and Care Network practices in PA)
  • Horizon Blue Cross Blue Shield, all commercial plans including Horizon NJ Plus
  • Humana ChoiceCare
  • Humana Military Services (TRICARE East)

I

  • Independence Blue Cross, all plans
  • Independence Administrators
  • Intergroup

K

  • Keystone 65
  • Keystone First *authorization required
  • Keystone Health Plan East (HMO, POS)
  • Keystone Health Plan East-PA Kid (PA CHIP)

L

  • La Colonial
  • LifeTrac (includes transplants and all CHOP services)

M

  • Mail Handlers Benefit Plan
  • MAMSI Life and Health *when managed by UBH
  • Medical Assistance – DE, PA, NJ
  • Medicare Part B
  • Multi-Plan

N

  • NJ Carpenter Fund

O

  • OneNet(Alliance)
  • Optum Health Networks (Transplant, CHD, Neonatology, Cancer)
  • Oxford, except Garden State Plan
  • Olympus

P

  • Pennfield Care Management
  • Personal Choice *when managed by Magellan
  • Personal Choice – PennCare
  • PHA Group
  • Plokin Consulting
  • Preferred Healthcare/PPHN (PPO) *benefits vary by client
  • Private Health Care Systems or PHCS (Hospital services, RACH, CAA, CHHC, and Care Network)
  • Pupa

Q

  • QualCare (all plans, excludes Virtua plans) *benefits vary by client
  • Quality Health Management

T

  • TRICARE East *working agreement may require authorization
  • TRICARE West* (Health Net Federal) *authorization required after eighth visit

U

  • United Behavioral Health *certain codes require authorization
  • United Healthcare (commercial plans)
  • United Healthcare Community Plan, Pennsylvania
  • United Healthcare Community Plan for Kids, Pennsylvania
  • United Healthcare Community Plan New Jersey
  • United Healthcare Community Plan, Delaware
  • UPMC, all commercial plans
  • UPMC for You
  • UPMC for Kids

Mental Health Diagnosis

A | C | D | E | H | I | K | M | P | Q | T | U |

A

  • Aetna Behavioral Health
  • Aetna Better Health Kids (CHIP)
  • AmeriHealth* (NJ: EPO, HMO, POS, PPO; PA: EPO, HMO, POS, PPO; DE: HMO, POS, PPO) *when behavioral health is managed by Magellan
  • Amerihealth 65 *when behavioral health is managed by Magellan
  • Amerihealth Administrators* (PPO) *when behavioral health is managed by Magellan

C

  • Cigna Behavioral Health
  • Community Behavioral Health (CBH)

D

  • Devon Health Services *benefits may vary by client

E

  • Employers Health Network *authorization required

H

  • Highmark BC/BS *authorization required

I

  • Independence Administrators *when behavioral health is managed by Magellan

K

  • Keystone Health Plan East* (HMO, POS) *when behavioral health is managed by Magellan
  • Keystone Health Plan East-PA Kids (PA CHIP)

M

  • Magellan Health Services, all commercial plans

P

  • Penn Behavioral Health *certain codes require authorization
  • Personal Choice (PPO, PHO, PennCare) *when behavioral health is managed by Magellan
  • Preferred Healthcare/PPHN (PPO) *benefits vary by client

Q

  • QualCare (all plans, excludes Virtua plans) *benefits vary by client

T

  • TRICARE East, all others *working agreement may require special authorization
  • TRICARE West* (Health Net Federal Services) *authorization required after eighth visit

U

  • United Behavioral Health *certain codes require authorization
  • United Healthcare Community Plan PA Kids (CHIP) *managed by United Behavioral Health
  • UPMC, commercial plans *when behavioral health is managed by UPMC


Next Steps
Pre-Visit Financial Counseling Hotline
Questions About Your Bill