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GENERAL QUESTIONS The deadline to complete enrollment in the 9/11 Mental Health & Substance Abuse Program was December 31, 2007. If you did not complete your enrollment by this date, you are no longer eligible for financial assistance with your 9/11 related mental health treatment costs. If you need assistance locating free or low-cost mental health and substance abuse treatment referrals, please call 1-800-LIFENET (1-800-543-3638), a service of the Mental Health Association of New York City (MHA of NYC). LIFENET is a confidential 24-hour hotline staffed with mental health professionals who can help you locate services in the NYC area. If you live outside of NYC, LIFENET can provide you with phone numbers for the mental health information and referral organization(s) in your area. Please note that the information below applies only to current enrollees of the Program. Back to List of QuestionsWhat type of financial assistance does the 9/11 Mental Health and Substance Abuse Program ("the Program") provide?
If you completed enrollment prior to the December 31, 2007 deadline, the Program helps cover the out-of-pocket cost of mental health and substance abuse treatment, including individual, family, couples and group counseling; auricular acupuncture; and psychotropic medication. The Program also helps you cover costs associated with inpatient treatment for mental health or substance abuse issues. Financial assistance is available for covered services up to a maximum dollar amount. You must have received the services within the 6 year period of September 11, 2001 to December 31, 2007. The program provides assistance with the cost of: If you are insured, you need to submit claims to your insurer first and then - if your insurance has not covered all the cost - submit your claims to our third party claims processing agent, QualCare. All claims for reimbursement must be submitted by March 31, 2008.
When I reach my benefit limit, can I request an exception for additional coverage if I am still in treatment? We do not grant extensions or exceptions to the program benefit limit. Your benefit coordinator can help you identify other 9/11 related programs that are still available, or, alternately, 1-800-LIFENET can help you locate free or low-cost mental health services in your community. Please visit our Resources page. The Program offers financial assistance only for services provided by a licensed private practitioner or by an employee of a licensed mental health or substance abuse program. You can receive services anywhere, but you must first verify with your provider that his/her license is recognized in the State where you are receiving services. What medications are covered under the program? The Program provides financial assistance with medications prescribed by a licensed professional for treatment of 9/11-related mental health or substance abuse issues. We maintain a list of program-approved medications that includes virtually every FDA-approved psychiatric medication currently on the market (and the foreign equivalent of such FDA-approved medications).
Please note that we need pharmacy receipts to process your claims for medications reimbursement. The benefit cannot pay pharmacies directly. You must pay for approved medications up front and submit claims with receipts to QualCare, the third party claims administrator for the 9/11 Mental Health and Substance Abuse Program.
Who funds and administers the 9/11 Mental Health and Substance Abuse Program? The Program was jointly created by the American Red Cross and The September 11th Fund. When The September 11th Fund closed in 2004, the Red Cross assumed sole financial responsibility for the Program. The Mental Health Association of New York City administers the Program on behalf of the Red Cross.
QUESTIONS ABOUT HOW THE PROGRAM WORKS WITH OTHER INSURANCE I already have insurance that includes mental health coverage. Am I still eligible for the program? Yes. The Program is designed to complement other insurance programs, not to take their place. We expect you to comply with the plan offered by your insurer and to submit any claims to your insurer first, before submitting them to the Program.
The Program assists with out-of-pocket expenses not covered by your insurance, such as deductibles and co-payments. In some circumstances we can cover the difference between partial payment by the insurer and the amount billed by the provider, as long as the total amount reimbursed by all parties does not exceed our fee schedule.
I have "in-network-only" mental health coverage under my insurance plan. Must I see a provider from this plan's network provider panel? Yes, with the following exceptions:
If you believe you qualify for one of these exceptions, please contact your benefit coordinator to be certain. If you do not remember the name of your benefit coordinator, please call (212) 614-6383.
QUESTIONS ABOUT IMPORTANT DEADLINES Is there a deadline for enrolling in the program? Yes. The deadline to complete your enrollment was December 31, 2007. We are unable to grant any exceptions to this deadline. You can call 1-800-LIFENET to gain access to free or low-cost mental health referrals in the New York area, or to speak with a trained mental health professional, 24 hours a day, 7 days a week.
How long is assistance available? The last date of service that can be covered through the Program is December 31, 2007. You also can submit claims for covered services you received as far back as September 11, 2001. When is the last day I can submit claims for covered services? Claims must be postmarked on or before March 31, 2008. The last date of service that can be covered through the Program is December 31, 2007. What if I am enrolled and decide not to participate? No problem. There is no penalty if you choose not to use the benefit, and your personal information is kept confidential. What happens if I am eligible for the program but have not filed any claims, and the program ends? Is the assistance set aside for me? No. All enrollees must submit claims by March 31, 2008 in order to access financial assistance. The program end date and related deadlines were communicated two years in advance in order to give people with 9/11-related needs ample time to enroll in the program, seek treatment, and submit claims for financial assistance. I do not remember whether or not I enrolled; how can I find out? Please call (212) 614-6384 and ask whether you completed your enrollment in the 9/11 Mental Health and Substance Abuse Program. You may be able to submit claims for services received on or before December 31, 2007, until March 31, 2008. What if I do not receive the explanation of benefits (EOB) statement from my insurance company prior to the March 31, 2008 deadline for submitting claims? Please speak to your benefit coordinator about any problems like this prior to the March 31, 2008 deadline. Are there other resources that can help me pay for therapy after this program has closed? LIFENET, 1-800-543-3638, can provide you with phone numbers for mental health services programs in the NYC area. If you live outside of NYC, LIFENET can provide you with phone numbers for the mental health information and referral organization(s) in your area. You can speak with your benefit coordinator about assistance that may be available to you from the New York State Crime Victims Board (CVB). If you are eligible, your benefit coordinator can help you apply to CVB. We encourage you to visit our Resources page for information on other 9/11-related services.
Why is the program ending in 2007? The 9/11 Mental Health and Substance Abuse Program was launched in August 2002 and funded through charitable donations to the American Red Cross and the September 11th Fund. It was designed to remove financial need as a barrier to treatment for people who were directly affected by the terrorist attacks and scheduled to last no more than five years. To date, nearly 13,000 people have enrolled. What happens if I submit a claim before the deadline and it is rejected for missing information? We will do our best to assist you and ask that you:
Please speak to your benefit coordinator about any specific problems or circumstances related to claims you submit prior to March 31, 2008.
QUESTIONS ABOUT SUBMITTING CLAIMS Once you are enrolled in the program, you will receive a package providing you with detailed information about submitting claims. Several factors will determine how your claims should be submitted:
Generally speaking, either you or your provider may submit claims to QualCare, our third party claims processing agent. If you are insured, however, you will submit claims to your primary insurer first and then to QualCare. Your benefit coordinator can answer any specific questions you have about claims submission. You can download a claim form ( I started seeing a therapist right after September 11th, but I enrolled only recently in the 9/11 Mental Health and Substance Abuse Program. May I submit claims for services I received prior to my enrollment? Yes, the program covers services retroactive to September 11, 2001 until December 31, 2007. All eligible claims must be submitted by directly to QualCare and must be postmarked by March 31, 2008. Please speak with your benefit coordinator about how to submit claims for services received prior to your enrollment in the program. If you do not remember the name of your benefit coordinator, please call (212) 614-6383.
OTHER QUESTIONS I am uninsured and I don't know how to locate a provider. Can you help? Yes. Once you have enrolled in the program, you can speak to a professional at LIFENET who has access to our Private Practice Referral Database. Please call (212) 614-5759, or outside New York City call 1-800-LIFENET and ask for extension 759. Providers are for the New York/New Jersey area only. |
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