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

  • Aetna* (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)
  • Aetna Better Health
  • AmeriHealth (NJ: EPO, HMO, POS, PPO; PA: EPO, HMO, POS, PPO; DE: HMO, POS, PPO
  • Amerihealth 65
  • Amerihealth Administrators (PPO)
  • AmeriHealth Caritas* (formerly AmeriHealth Mercy) (PA Medicaid) *our contract does not apply to any NJ site
  • AmeriHealth Northeast* (PA Medicaid) *par via the Keystone First/AmeriHealth Caritas contract

C

  • Carelink Health Plans (W. Virginia Medicaid HMO)
  • CareNet Health Plans (VA Medicaid HMO)
  • Cigna Health Plans* (HMO, PPO) *when behavioral health is managed by CIGNA Behavioral Health
  • Coventry Cares (PA Managed Medicaid)
  • Coventry Cares (Kentucky, Nebraska Medicaid HMO)
  • Coventry Transplant
     

D

  • Devon Health Services

E

  • Employers Health Network 

H

  • HealthCare USA (MO Medicaid HMO)
  • Health Partners of MN* (commercial plan) par via affiliation with Cigna Commercial
  • Highmark BC/BS (EPO, PPO, Indemnity, Others)

I

  • Independence Administrator (PPO)

K

  • Keystone 65
  • Keystone First (PA Medicaid, formerly Keystone Mercy Health Plan)
  • Keystone Health Plan East (HMO, POS)

L

  • LifeTrac

M

  • MAMSI Life and Health 

N

  • NJ Carpenter Fund

O

  • Omnicare Health Plan (MI Medicaid HMO)
  • Optum Health (Transplant, Cancer, CHD Networks)
  • Oxford
     

P

  • PENN Behavioral Health
  • Personal Choice
  • Preferred Healthcare/Pennsylvania’s Preferred Health Networks (PPO)

Q

  • QualCare

T

  • Tricare North* (Health Net Federal) *authorization required after eighth visit
  • Tricare South, West, all others (working agreement may require special authorization)

U

  • United Healthcare (all plans)
  • United Health One (Golden Rule Insurance Plan)
  • United Healthcare Community Plan PA Families (PA Medicaid)
  • United Healthcare Community Plan PA Kids (CHIP)
  • United Healthcare Community Plan NJ (NJ Managed Medicaid, CHIP)

V

  • Vista

Mental Health Diagnosis

A

  • Aetna Behavioral Health (CDHP, Elect Choice, POS, HMO, PPO, Managed Choice, Traditional Choice, US Access, Chickering Group, Signature Administrators)
  • 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
  • Coventry Transplant

D

  • Devon Health Services

E

  • Employers Health Network

H

  • Highmark BC/BS (EPO, PPO, Indemnity, others)

I

  • Independence Administrator* (PPO) *when behavioral health is managed by Magellan

K

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

M

  • Magellan Health Services (Comcast employees only)

P

  • Penn Behavioral Health
  • Personal Choice *when behavioral health is managed by Magellan
  • Preferred Healthcare/PPHN (PPO)

Q

  • QualCare

T

  • Tricare North* (Health Net Federal) *authorization required after eighth visit
  • Tricare South, West, all others (working agreement may require special authorization)

U

  • United Behavioral Health
  • United Healthcare Community Plan PA Kids (CHIP) managed by UBH