VNS Health EasyCare Plus: Inpatient Services in a Psychiatric Hospital

When someone is in mental crisis, admission into a psychiatric hospital may be necessary. A person may voluntarily admit themselves to a psychiatric hospital, or they may be involuntarily admitted to the hospital in the event that they are determined by a psychiatrist and a judge to be a danger to themselves or others, or are gravely disabled, and either knowingly deny admission or are unable to consent to admission. Examples of crises include suicidal or homicidal ideation, uncontrolled symptoms and behaviors associated with post-traumatic stress disorder, aggressive dementia-associated behaviors, and psychosis associated with mental or mood disorders, among others.

The plan covers up to 190 days in a lifetime for inpatient services in a psychiatric hospital. Inpatient psychiatric hospital services count toward the 190-day lifetime limit only if certain conditions are met. The 190-day limit does not apply to inpatient mental health services furnished in a general hospital.

*Note that psychiatric care provided within a general hospital, on a locked unit, designated for psychiatric care, is considered the same as psychiatric hospital care. Inpatient mental health services furnished in a general hospital means that the individual is admitted to a general hospital unit (not a psychiatric unit) for another condition, yet also receiving psychiatric services. The former counts toward the 190 lifetime limit, the latter does not.

Your loved one is eligible for additional mental health benefits from Medicaid.