Premier Option Plus
Premier Option Plus is a Health and Recovery Plan, or HARP, approved by New York State. Premier Option Plus is a new kind of plan that provides Medicaid members with specific behavior health needs, with an enhanced benefit package so they can receive their health care, plus care for behavioral health such as mental health, substance use disorder and rehabilitation from one integrated plan.
Premier Option Plus is a special health care plan with providers who have a lot of experience treating persons who may need mental health and/or substance use care to get healthy, be healthy and stay healthy. We also provide care management services to help you and your health care team to work together to keep you as healthy as possible. You and your health care team will work together to make sure you enjoy the best physical and emotional health possible. You can get special services for healthy living, such as nutrition classes and help to stop smoking. In addition, Premier Option Plus offers care coordination to help you reach your goals.
To be eligible for Premier Option Plus, you must be 21 years of age or older, Medicaid eligible, do not have Medicare and reside in our service area.
Beginning October 1, 2016, Premier Option Plus will offer new services called Home and Community Based Services (HCBS). HCBS can help you with life goals such as employment, school, or other areas of your life you want to work on. To find out if you qualify, a Health Home Care Manager must complete a brief screening with you that will show if you can benefit from these services. If the screening shows you can benefit, the Care Manager will complete a full assessment with you to find out what your whole health needs are including physical, behavioral and rehabilitation services.
Behavioral health care includes mental health and substance use (alcohol and drugs) treatment and rehabilitation services. All of our members have access to services to help with emotional health, or to help with alcohol or other substance use issues. These services include:
Mental Health Care
Substance Use Disorder Services
Premier Option Plus may help you
Benefits You Can Get From Our Plan or With Your Medicaid Card:
For some services, you can choose where to get your care. You can get these services by using your Blue Option Plus membership card. You can also go to providers who will take your Medicaid Benefit card. You do not need a referral from your PCP to get these services. Call Member Services if you have questions at 1-800-650-4359.
To find out more about how to access these services, please talk to your provider or contact Member Customer Care at 1-800-650-4359.
If you are experiencing a crisis you can call us at 1-800-650-4359.
Transitional Age Youth (TAY):
For more information on resources and services available to young people transitioning to adult hood please visit the Office of Mental Health (OMH) website. This site will provide a complete listing of resources for the young adult and their family.Learn More
Advocacy Organizations/Volunteer Opportunities/Support Services/Community Forums:
There are many opportunities available for members and their families to get involved in volunteer activities, committees, work groups, community forums and connect with advocacy services. Listed are some of the community organizations that are available to our members and their families for support, guidance and advocacy.
We also offer Behavioral Health Care Management services to our members and their families. Our Behavioral Health Care Managers can assist you with understanding your insurance benefits, understanding your treatment options, locating and connecting with area treatment providers for mental health and substance use treatment and much more. If you or a loved one have questions or need assistance please reach out to one of our Behavioral Health Care Managers who can be reached at 1-800-650-4359. A Behavioral Health Care Manager will be able to assist you during our normal business hours. If calling after hours you will be connected with a live nurse through Nurse Wise.
We also offer Behavioral Health Advocacy services to our members and providers when a request for treatment has been denied. Our Behavioral Health Advocate is available to assist you and your provider in understanding the denial decision as well as with the process for pursuing appeals, and in identifying participating providers. Our Behavioral Health Advocate can be reached at 585-485-6020.
National Alliance on Mental Illness (NAMI) offers local support groups. A state search can be done find all the support groups in that state listed by county.
For Monroe, Livingston and Wyoming Counties, the Mental Health Association offers listings of services and support groups.
National Eating Disorder Association will provide information on the diagnoses and also provides assistance with finding eating disorder providers and supports.
Substance abuse and Mental Health Services Administration site provides general mental health and substance use information along with news and updates. There is also a Behavioral Health treatment locator tool that is available.
Substance Abuse and Mental Health Services Administration (SAMHSA) offers crisis support and general information on mental health and substance use
New York State Office of Mental Health (OMH) offers listings of mental health resources in NYS
Depression and Bipolar Support Alliance (DBSA) offers local support groups that can be searched by state.
National Institute of Mental Health site provides general mental health and substance use information
Alcoholics Anonymous is a group of peers open to everyone who has struggled with alcohol. This site offers information on AA.
Alcoholics Anonymous offers support groups run by peers offering support and guidance. This site provides a listing of area AA meetings.
Narcotics Anonymous offers support groups run by peers offering support and guidance to those who wish to pursue and maintain a drug-free lifestyle. This site offers information on Narcotics Anonymous and also a listing of area NA Meetings.
Spiritus Christi Church is located in the Rochester area and offers free mental health services and support groups.
Secular Organizations for Sobriety is an informational site on SOS which is a nonprofit network of autonomous, nonprofessional local groups dedicated solely to helping individuals achieve and maintain sobriety. There are groups meeting in many cities throughout the US and other countries.
Al-Anon offers support to friends and families of problem drinkers. This site offers information on Al-Anon and provides information on local Al-Anon support groups.
National Council on Alcoholism and Drug Dependence - Rochester Area organization offers community education on addiction related topics.
Family Recovery Network support group providing information and networking for families of people struggling with substance use in the greater Rochester, NY area.
Premier Option Plus (PDF)
Websites for reference:
Language Assistance and Non-Discrimination Notice
Copyright © 2016, Premier Health Plan. All rights reserved.