Federal Employee Mental Health Benefits

All FEHB plans include mental health and substance use disorder benefits as essential health benefits. This means your plan may cover services like psychotherapy, psychiatric evaluation, medication management, and — when medical necessity criteria are met — advanced treatments like TMS.

The specific services covered, and the amount your plan pays, depend on which carrier and plan you're enrolled in. FEP Blue, Aetna, GEHA, MHBP, and other FEHB carriers each have their own networks, formularies, and coverage policies.

• Psychiatric evaluation and consultation
• Psychotherapy and counseling sessions
• Medication management and psychiatric follow-up
• TMS therapy when medical necessity criteria are met
• Accelerated TMS protocols (plan and policy dependent)
• SPRAVATO (esketamine) for treatment-resistant depression

Coverage for advanced treatments like TMS and SAINT depends on your specific plan's medical policy, your diagnosis, and your treatment history. Prior authorization is typically required.

Under the Mental Health Parity and Addiction Equity Act, FEHB plans must treat mental health and substance use disorder benefits on par with medical and surgical benefits. This means copays, deductibles, and treatment limits for mental health care should be no more restrictive than those for other medical care.

The best way to understand what your plan covers is to verify your benefits. Our team can review your FEHB or PSHB plan, explain what treatment options may be available, and handle the authorization process.

Call (954) 827-9793 or start the verification process.