Treatment

Unless you can pay cash for mental health treatment for you or your child, the first step to getting help is to contact your insurance company.

Private/Commercial insurance

Information regarding mental health coverage through your private/commercial insurance can be found in your plan’s enrollment materials, or any other information you have on the plan. Because of the Affordable Care Act, health insurers are required to provide you with an easy-to-understand summary about your benefits including mental health benefits, which should make it easier to see your coverage.

You can also call the toll-free number on the back of your insurance card for “Behavioral Health” or “Mental Health” services. Behavioral Health is typically a term that refers to mental health and/or drug and alcohol treatment. When you call that toll-free number, a representative should be able to explain how to get mental health services for either you or your covered child.

If there is no number for “Behavioral Health” or “Mental Health” on the back of your insurance card, you can call the Customer Service number or contact your place of employment for instructions on how to access mental health treatment.

Medical Assistance/Medicaid

Medical Assistance/Medicaid is often referred to as MA or the Access card. There are many mental health services that are available through Medical Assistance for children and adults. Click here to see A Guide for Parents Seeking Mental Health Services for Children in Berks County. (this link will take you to the Guide that is on the MH/DD Program website)

If you or your child are enrolled in Medical Assistance in Berks County, behavioral health services are paid for by Community Care Behavioral Health (CCBH) organization. You can contact CCBH at 1-866-292-7886 and a representative will help you find a mental health agency where you or your child can go for an evaluation and treatment.

You can also visit their website at ccbh.com for a list of providers in the CCBH network.

Medicare

Medicare covers a wide range of mental health services.

If you have questions about mental health services through original Medicare, please call 1-800-MEDICARE (633-4227) or visit https://www.medicare.gov.

If you get your Medicare benefits through a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan, check your plan’s membership materials or call the plan for details about how to get your mental health benefits.

Two or more of the above

If you have: Private/Commercial insurance AND Medical Assistance

You MUST seek services through your private/commercial insurance first. Medical Assistance might cover services or costs that the private insurance does not cover so it is a good idea to pick a mental health agency that accepts both your private/commercial insurance AND Medical Assistance. Select the Private/Commercial insurance option above to learn how to get mental health treatment services through your private/commercial insurance plan.

If you have: Medicare AND Medical Assistance

You MUST seek services through Medicare first. Medical Assistance might cover services or costs that Medicare does not cover so it is a good idea to pick a mental health agency that accepts both Medicare and Medical Assistance.

Select the Medicare option above to learn how to get mental health treatment services through Medicare.

I don’t have any insurance

If you or your child are in need of mental health treatment and not currently enrolled in or eligible for any insurance please contact Service Access and Management, Inc. at 610-236-0530 and ask to speak with an intake worker.

You can also walk into Service Access and Management Monday – Friday between the hours of 8:00AM and 1:00PM and request an intake. The address for Service Access and Management is 19 N. Sixth Street, 3rd Floor, Reading, PA 19601

Please bring the following documents with you for your intake at Service Access and Management:

• A copy of a mental health evaluation/diagnosis from your current treatment provider, if available
• Insurance information – Medical Assistance card, Medicare card, private insurance card, etc.
• Income information – tax return, three(3) consecutive pay stubs, Social Security benefit information, unpaid medical bills within the past year, etc.

During the intake at SAM, a case manager will determine if you or your child meet the criteria for public funding for mental health treatment services. If you or your child qualify for public funding for mental health treatment, you will be expected to comply with the process of applying for Medical Assistance.

You are also able to apply for Medical Assistance on your own through the Pennsylvania COMPASS website at www.compass.state.pa.us. COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information. You can also apply for Medical Assistance in person at:

Berks County Assistance Office
Reading State Office Building
625 Cherry Street, 3rd Floor
Reading, PA 19602

If you are applying for Medical Assistance for your child who has a disability, you MUST provide proof of your child’s disability along with your Medical Assistance application.