CareAdvantage Dual Eligible Special Needs Plan (D-SNP) 2025

Behavioral Health

How to get mental health and substance use disorder services

You have access to medically necessary behavioral health services that are covered by Medicare and Medi-Cal. CareAdvantage provides access to behavioral health services covered by Medicare. Medi-Cal covered behavioral health services are not provided by CareAdvantage, but are available to eligible CareAdvantage members through San Mateo County Behavioral Health and Recovery Services (BHRS). CareAdvantage members need to use their Medi-Cal card to get these behavioral health services.

To access Mental Health services, you can speak with your doctor or call the BHRS ACCESS Call Center at 1-800-686-0101 (TYY: 7-1-1) for more information and they will route you to the right services. The hours are Monday through Friday, 8:00 a.m. to 5:00 p.m.

What Medi-Cal behavioral health services are provided outside of CareAdvantage through San Mateo County Behavioral Health and Recovery Services (BHRS)?

Medi-Cal specialty mental health services are available to you through the county mental health plan (MHP) if you meet Medi-Cal specialty mental health services medical necessity criteria. Medi-Cal specialty mental health services provided by BHRS include:

• Mental health services (assessment, therapy, rehabilitation, collateral, and plan development)
• Medication support services
• Day treatment intensive
• Day rehabilitation
• Crisis intervention
• Crisis stabilization
• Adult residential treatment services
• Crisis residential treatment services
• Psychiatric health facility services
• Psychiatric inpatient hospital services
• Targeted case management

Drug Medi-Cal services are available to you through BHRS if you meet the Drug Medi-Cal medical necessity criteria. Drug Medi-Cal services provided by BHRS include:

• Intensive outpatient treatment services
• Residential treatment services
• Outpatient drug free services
• Narcotic treatment services
• Naltrexone services for opioid dependence

In addition to the Drug Medi-Cal services listed above, you may have access to voluntary inpatient detoxification services if you meet the medical necessity criteria.

You can call the BHRS ACCESS Call Center at 1-800-686-0101 (TYY: 7-1-1) for more information. The hours are Monday through Friday, 8:00 a.m. to 5:00 p.m. You should contact the BHRS ACCESS Call Center if you need help getting behavioral health services. BHRS is responsible for initial behavioral health screening to ensure the appropriate level of care.

If you have a problem with a BHRS provider, you can contact the BHRS ACCESS Call Center at the number listed above, OR you can call the CareAdvantage Unit at 1-866-880-0606, TTY 1-800-735-2929, Monday through Sunday, 8:00 a.m. to 8:00 p.m. to file a grievance.