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Primary and Acute Care Services – Physical Health
The following are covered benefits under the QUEST Integration.
Primary and Acute Care Services
Behavioral Health Services
Additional Behavioral Health Services for Children
Additional Behavioral Health Services for Adults
Long-Term Services and Supports
services
Primary and Acute Care Services – Physical Health
Behavioral Health Services
Additional Behavioral Health Services for Children
Children/youth less than twenty-one (21) years old with a diagnosis of serious emotional behavioral disorders are eligible for additional behavioral health services within the Department of Health, Child and Adolescent Mental Health Division (CAMHD) Support for Emotional and Behavioral Development (SEBD) program.
Additional Behavioral Health Services for Adults
Adult members age twenty-one (21) years of age or older with a diagnosis of serious and persistent mental illness (SPMI) who are eligible for additional behavioral health services shall receive those services through the Community Care Services (CCS) program.
Long-Term Services and Supports (LTSS)
The health plan shall provide these services to members who meet appropriate level of care. Long-term services and supports (LTSS) are divided into two categories:
Services must be applied for and are available based on physician’s evaluation of required level of care.