How to Navigate Insurance, Find Providers, and Access Support
If you are concerned about your child’s behavioral health, want to seek an assessment, or are interested in learning more about services and support, you can initiate behavioral health care. The steps differ depending on whether your family has commercial or private health insurance or coverage through the Arizona Health Care Cost Containment System (AHCCCS).
Behavioral health resources can include counseling, family coaching, skills training and more. Many services are now offered through virtual or online appointments, regardless of insurance plan. Here’s how to start the process.
USING COMMERCIAL INSURANCE
If you have coverage through a private or commercial insurance plan, check the back of your insurance card for a phone number. It may be listed as Behavioral Health, Mental Health/Substance Abuse or Customer Service. Call that number to connect with in-network agencies that provide behavioral health services. Follow these steps for plans purchased through the Health Insurance Marketplace.
Ask for a list of in-network providers and details on your coverage. They should provide names of clinicians such as therapists, psychologists and psychiatrists. Ask whether you need a referral or authorization and what your copay and deductible amounts are. Depending on your child’s needs and diagnoses, they may be referred for treatment or assigned a behavioral health case manager.
Your insurance provider may also have a website or portal where you can search for in-network therapists by specialty, such as ADHD, anxiety, autism or trauma. You can also see which providers are accepting new patients.
Online therapy directories include:
When using directories, include your insurance plan and your child’s age for the most accurate results.
Verify coverage with your insurance provider. Many private plans cover counseling or therapy, psychiatric evaluation, medication management, neuropsychological or psychological evaluations (or partial coverage), intensive outpatient programs (IOP) and partial hospitalization programs (PHP). Private plans often cover Applied Behavioral Analysis (ABA) for patients with an autism diagnosis; confirm benefits with your insurer. You may still have copays or coinsurance, so request cost estimates.
If your child needs immediate help, your insurance provider may have a rapid-access behavioral health phone line. You can also call or text 988 for urgent support or visit a walk-in clinic such as MIND 24-7.
USING AHCCCS INSURANCE
Referrals are not required for individuals covered by AHCCCS, including plans through the Arizona Long-Term Care System (ALTCS). Call any contracted behavioral health provider in the state to request an intake.
You can also call your child’s AHCCCS health plan for assistance, including a list of in-network agencies. AHCCCS plans can provide transportation for medical or therapy appointments.
Families with AHCCCS can contact the Regional Behavioral Health Authority (RBHA) for their area.
REGIONAL BEHAVIORAL HEALTH AUTHORITIES:
- Maricopa County (Phoenix Area): Mercy Care 800-564-8465
- Pima County (Tucson Area): Arizona Complete Health 866-495-6738
- Northern Arizona: Health Choice Arizona 800-640-2123
For children in foster or kinship care, Arizona has open access, meaning any behavioral health provider must see a child within 72 hours for urgent concerns or within 21 days for routine care. Call the Mercy Care DCS Specialty Plan at 833-711-0776 to request an appointment.
AHCCCS-covered services can include individual and family therapy, psychiatric evaluations, medication management, psychological testing when medically necessary, autism evaluations and ABA therapy. Services often include case management, in-home support and skills training, and may provide intensive outpatient or hospitalization services when needed. Behavioral health teams may also offer wraparound services to help children remain in their homes and communities instead of residential settings.
The Office of Individual and Family Affairs (OIFA) under AHCCCS offers resources.
Caregivers of patients receiving AHCCCS behavioral health services can request respite care. This short-term break for parents or primary caregivers must be included in a service plan and authorized in advance. The plan will define frequency, duration, setting (home or facility) and goals. For foster/adoptive families or those with DCS involvement, requesting respite may also involve contacting the DCS caseworker.
EMERGENCY NEEDS
If your child, teen or adult has urgent behavioral health needs, Arizona has statewide 24/7 crisis lines available to anyone, regardless of insurance.
- Statewide (all counties): 844-534-4673 (HOPE) or text 4HOPE
- Maricopa County: 602-222-9444
- Pima County: 520-622-6000
Teams can come to your home if needed. A statewide list of crisis hotlines is available.
With any insurance, you can also contact your child’s pediatrician or primary care provider for an initial screening and next steps. Even if a referral isn’t required, this keeps the doctor informed of treatment plans, which can help if referrals are needed later.
If seeking behavioral health services for an adult, you may need power of attorney paperwork or documents with the agency to participate in care planning. If you have full or partial guardianship, including medical decision-making, you should be able to speak with providers without additional documents.
For more information about navigating behavioral health services for your family, contact Encircle Families by calling 602-242-4366 or emailing info@encirclefamilies.org.
