Behavioral Health Coverage

Blue Cross and Blue Shield of Texas offers health care for your body and mind. Sometimes you may need help dealing with stress, grief, or depression. Help is also available for those facing:

• Mental health conditions
• Substance use (alcohol, drugs)
• Behavioral health crisis

The type of help you might need depends on your personal situation. It could be counseling, treatment, in-patient or out-patient care. BCBSTX provides Service Coordination to help you get the care you need.

Behavioral health care does not need approval from your primary care provider (PCP). You also may want to talk to your PCP about the problem.

If you are an adult who has a mental illness or if you have a child with emotional needs, this benefit can help you or your child to learn how to be your best. We can help you with:

• Arranging mental health rehabilitation services
• Managing your medicine to reduce your symptoms or so that you can be more independent
• Training to help you talk to your family, friends and teachers about how you can work together to control your symptoms
• Dealing with a mental or emotional crisis

Blue Cross and Blue Shield of Texas offers the following as In Lieu of Services (ILOS) for STAR Kids members: 

• Partial Hospitalization
• Intensive Outpatient Program
• Coordinated Specialty Care
• Learn more about ILOS

What is Covered?

Some services covered by your plan include:

• Alcohol or drug treatments
• Applied Behavioral Analysis (ABA) therapy for children diagnosed with Autism Spectrum Disorder (ASD)
• Care during a hospital stay
• Community-based behavioral health services
• Crisis services
• Day treatment at a hospital
• Intensive outpatient program
• Medication assisted treatment
• Outpatient services, such as a drug management, therapy and counseling
• Residential treatment of substance use

Check the  STAR Kids Member Handbook  to learn more about plan benefits.

Find out more about covered behavioral health programs and services.

Applied Behavioral Analysis for Children with Autism Spectrum Disorder

Applied Behavioral Analysis (ABA) therapy is a benefit for STAR members as a covered benefit through Texas Medicaid. ABA can help children with Autism Spectrum Disorder (ASD) develop improved function with their peers and caregivers. To qualify for ABA, your child must first have special testing to confirm their diagnosis of ASD.

ABA testing is more thorough than what most pediatricians can do as part of their practice. The testing must be performed by a specialist such as a developmental pediatrician, a neurologist, a psychiatrist, a licensed psychologist, or an Autism diagnosis team. Speak to your child’s pediatrician about getting a referral to one of these specialists.

Please check the ABA therapy Frequently Asked Questions for more information.

Go to Provider Finder^® to search for and print a list of ABA providers in your area.

If you have more questions about ABA services, please call STAR Kids Service Coordination toll-free at 1-877-301-4394. Members with hearing or speech loss can call the TTY line at 711. We are open 8 a.m. to 5 p.m. Central Time, Monday through Friday. You may leave a voicemail outside of our normal business hours or on weekends and holidays. You will be able to talk to a mental health professional.

Learn to Live provides educational behavioral health programs. Members considering further medical treatment should consult with a physician. Learn to Live, Inc. is an independent company that provides online behavioral health programs and tools for members with coverage through Blue Cross and Blue Shield of Texas. BCBSTX makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.