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Understanding U.Va.’s Mental Health Benefits

July 29, 2004

Staff Report

Let’s suppose Mary Jones is a U.Va. employee who’s been feeling stressed lately— perhaps she’s depressed about a family member’s illness, worried about her teenager, in conflict with a co-worker or going through a divorce. She realizes that she needs someone to talk to, but she may not know that calling the Faculty and Employee Assistance Program is the best place to start.

Like all employees, Mary Jones can call FEAP and make an appointment to receive free and confidential help in assessing a problem and taking the most appropriate next step. If short-term counseling will help, she can see one FEAP’s five licensed clinicians, whose offices are located on the 7th floor of the Blake Center. If a referral to an outside counselor is needed, FEAP can give her or a family member the names of several qualified professionals with appropriate expertise and refer the person to that counselor.

What the staff can NOT do is give a referral after an employee has already made contact with an outside counselor without going through FEAP first, said Rebecca Mason, a nurse who works with the program. In such cases, an employee enrolled in the U.Va. Health Plan may be liable for a co-payment and other costs, based on whether or not the provider is in the network.

In the point-of-service plan, if Jones sees a FEAP counselor, obtains a referral, makes her appointment with the recommended counselor and then notifies FEAP prior to the first visit, the co-payment will be waived for the first eight visits during that course of treatment. After more than eight visits, a $30 co-payment per visit will apply.

If someone with point-of-service chooses not to go to FEAP, then there are other options. The employee can contact his or her primary care physician to obtain a referral to a network provider of their choice and then pay a $30 co-payment per visit. (Referrals are not retroactive.) Alternatively, the employee can choose to see a network counselor without a referral and owe a $40 co-payment per visit.

If Jones has the direct-access plan, she does not need a referral for mental health services, but she will have to make a $40 co-payment for each non-referred visit to a network provider. Although there is no waiver of the co-payment for a FEAP referral, employees in the direct access plan are still encouraged to contact FEAP to get the most appropriate referral.

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