Fresno Unified School District
Simple Behavioral
If you are enrolled in Medical Plan Option A or B, your mental health & substance abuse coverage is through Simple Behavioral. Preauthorization is required for all mental health and substance abuse services. If you are enrolled in Medical Plan Option C, your coverage is through Kaiser.
| Mental Health Services | Participating Provider | Non-Participating Provider |
|---|---|---|
|
Deductible Combined with Medical |
None |
Plan A $750 / Plan B $3,000 - Person Plan A $1,500 / Plan B $6,000 - Family |
|
Annual Out-of-Pocket Maximum Combine with Medical |
Plan A $2,100 / Plan B $5,700 - Person Plan A $4,200 / Plan B $11,400 - Family |
Plan A $10,000 / Plan B $12,000 - Person Plan A $20,000 / Plan B $24,000 - Family |
|
Inpatient, Partial and Day Treatment Prior authorization required for all inpatient services |
100% | Plan A 60% / Plan B 50% of UCR, Subject to Deductible |
| Outpatient Office Visits |
100% after $10 Copay Copay waived for substance use disorder |
Plan A 60% / Plan B 50% of UCR, Subject to Deductible |
Any questions pertaining to your mental health and/or substance abuse coverage can be directed to Simple Behavioral by calling 888.425.4800 or visiting their website at https://go.simpletherapy.com/fresnousd.