Carelon Behavioral Health Insurance for Mental Health Treatment

January 6, 2026

Authored by: Meagan Burkhart,

Edited by: Jemma Strain, B.S. Psychology

Finding the right mental health treatment for your child can feel overwhelming, especially when you need to consider the costs. Understanding exactly what your insurance covers and how to access care can help you feel more prepared and supported. Formerly known as Beacon Health Options, Carelon Behavioral Health offers comprehensive coverage for individuals and families.

This article provides an overview of Carelon Behavioral Health coverage. The goal is to help you find the mental health care your child needs, while also addressing any financial concerns. We will cover the following topics:

What is Carelon Behavioral Health coverage?
Your options for Carelon mental health services
Levels of care covered by your Carelon mental health benefits
Mental health conditions covered by Carelon
Understanding Carelon dual diagnosis coverage
A simple guide to the Carelon insurance verification process
Additional help for Carelon subscribers

What Is Carelon Behavioral Health Coverage?

Carelon Behavioral Health provides insurance coverage for over 61 million members across the country. With over 40 years of experience in the business, their goal is to support both mental and physical healthcare for whole-person, holistic treatment.¹

If you and your family have Carelon Behavioral Health coverage, there is a wide range of mental health benefits that you potentially qualify for. Depending on your specific plan, Carelon Behavioral Health coverage can include the cost of outpatient therapy, crisis care, and long-term care management for a variety of mental health concerns.²

The company’s specialty services address the needs of children, adolescents, and families. If your child is working to manage their mental health condition, Carelon Behavioral Health coverage can help reduce the financial pressure of treatment.³

Understanding Your Options for Carelon Mental Health Services

It’s important to understand the full range of Carelon mental health services when you’re searching for the right provider for your child. What Carelon covers depends on medical necessity—clinical criteria backed by research that helps Carelon determine the level of mental health treatment your child needs.⁴

Carelon offers five main categories of mental health services to cover different patient needs:

1. Specialty Care Services include treatment for specific mental health conditions, such as Autism spectrum disorder, eating disorders, or substance use disorder. This category also includes a child’s first behavioral health hospitalization, child psychiatry consultations, and peer support.⁴
2. Crisis Solutions provides immediate help during urgent situations. They include crisis phonelines, mobile crisis units, and rapid connection to Carelon’s network of providers for urgent care.⁴
3. Carelon Wellbeing is an Employee Assistance Program (EAP) that can help connect you to counseling and other resources for both yourself and your child.⁴
4. Carelon Health Federal Services offers behavioral health support for veterans and their families, often with a focus on trauma-related care.⁴
5. Workforce Mental Health Complete provides mental health resources for employers and their teams.⁴

This article focuses on Carelon’s Specialty Care Services and Crisis Solutions. These are the two categories most useful for parents looking for timely, effective mental health care for their child. If you’re new to Carelon or navigating behavioral health coverage for the first time, taking a moment to understand these categories can help you decide which services are right for your family.

Levels of Care Covered by Your Carelon Mental Health Benefits

Receiving a formal mental health diagnosis can be overwhelming when caring for a child. Depending on the severity of their condition, your child may be referred to different levels of mental health services. It’s important to understand which levels of care are included in your Carelon mental health benefits. Below are several types of care that may be available to your family:

Outpatient Therapy

Carelon insurance therapy coverage is comprehensive and typically includes a range of outpatient individual and group therapy options. You may have access to different therapeutic modalities, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), or acceptance and commitment therapy (ACT).

Inpatient Care

If your child is experiencing severe mental health symptoms or if safety becomes a concern, they may receive a recommendation for inpatient psychiatric care. Carelon inpatient mental health coverage is robust, and when medically necessary, these services are typically covered in full by your insurance.

Residential Treatment

Carelon residential treatment coverage is included if your child undergoes a formal mental health evaluation that demonstrates this level of care is necessary. A psychiatric evaluation will likely be carried out by a board-certified psychiatrist to assess your child’s symptoms and behaviors, as well as the clinical diagnosis that warrants residential mental health treatment.

Mental Health Rehab

Rehab for addictions, like substance use disorders, is generally covered by Carelon Behavioral Health. Carelon mental health rehab options are found across the country, and based on clinical recommendations, these services may be completely covered for you or your loved one.

If you’re unsure which level of care is appropriate for your child, Mission Prep can help. Get in touch with us, and our team can conduct an evaluation and make treatment recommendations that account for your specific insurance coverage.

Mental Health Conditions Covered by Carelon

Mental health treatment isn’t a one-size-fits-all solution. Different conditions may require unique care models, so understanding the various mental health conditions covered by Carelon can help guide your search.

Depression

Depression affects many adolescents today, and continues to be a growing health concern. With Carelon insurance, depression treatment is covered when it meets medical-necessity criteria, which may include outpatient therapy, inpatient care, residential treatment, partial hospitalization programs, and intensive outpatient programs.

Anxiety

Anxiety disorders are also common among teens. Carelon anxiety therapy coverage includes a wide range of specialized services, from weekly outpatient therapy to more intensive structured therapy programs as needed.

PTSD

Post-traumatic stress disorder is another serious mental health condition affecting adolescents today. If your child has been exposed to trauma and is showing concerning symptoms, getting the right treatment is essential. Carelon PTSD treatment coverage includes specialized, evidence-based interventions such as Eye Movement Desensitization and Reprocessing (EMDR) and trauma-focused CBT programs.

The conditions listed above represent only a portion of the diagnoses that qualify for Carelon mental health coverage.Mental health treatment isn’t a one-size-fits-all solution. Different conditions may require unique care models, so understanding the various mental health conditions covered by Carelon can help guide your search.⁵Securing an accurate diagnosis for your child is an important first step, and Mission Prep can help you navigate this process while working with your insurance to confirm what is covered.

Understanding Carelon Dual Diagnosis Coverage

A dual diagnosis is when your child is diagnosed with both a mental health condition and a co-occurring substance use disorder. This combination can make finding the appropriate mental health treatment option more complex, so it’s helpful to understand Carelon dual diagnosis coverage in advance.

Carelon covers a wide range of dual diagnosis services, including multiple levels of care. Depending on medical necessity, your child may be approved for inpatient treatment, outpatient mental health treatment, rehab, or residential care. Your plan should cover some or all of these options when medically necessary.

A Simple Guide to the Carelon Insurance Verification Process

If you are ready to contact Mission Prep for treatment recommendations for your child, the first step is verifying your insurance benefits. Completing this step prior to your child’s initial visit will help you avoid delays and unexpected bills and reduce the risk of a claim being denied.

Follow these steps in the Carelon insurance verification process:

Go to the insurance verification section of our website, where you’ll find a simple fillable form.
Complete the sections for your name, date of birth, and insurance information.
Submit a copy of your Carelon health insurance card and any referral documents you may have.
Contact us for additional help. If you’re having trouble filling out the form or would prefer to speak to someone directly, our team can walk you through the process and assist with verifying your Carelon health insurance.

After you submit all the required information and documentation, you will receive a response from a member of the Mission Prep team. They will explain which services are covered under your Carelon behavioral health plan, along with any expected costs, such as copays, deductibles, or coinsurance. If you have any further questions about your specific plan benefits, you can speak with your insurance representative and work with Mission Prep to share any information needed.

Additional Help for Carelon Subscribers

For extra resources to support your search for quality mental health treatment, you can visit Carelon’s blog, Perspectives. There, you will find articles covering a wide range of topics, including mental health education, substance abuse resources, and more detailed information about the Carelon mental health help available to you.

Carelon also provides links and contact information for the following nationwide mental health supports:

National Alliance on Mental Illness (NAMI)

NAMI provides education, support, and advocacy for individuals and families affected by mental health issues.

Suicide & Crisis Lifeline

Call or text 988 or visit 988lifeline.org to chat 24 hours a day, seven days a week.

Reaching out for support in times of crisis is crucial. Never hesitate to use any available resources if you are concerned about your child’s safety.

Mission Prep: Assisting Your Search for Services in the Carelon Behavioral Health Network

We know that finances are often a concern when searching for the right mental health treatment. Although quality services can be costly, you can reach out to Mission Prep to help you find the best options to support your child’s mental health needs.

Our team has the resources to connect you with Carelon-covered services that fit your situation. We can provide information on different levels of mental health care, including inpatient treatment, outpatient therapy, residential treatment, and intensive outpatient programs.

Contact us today to connect with a member of our team. They can help guide you through the insurance verification process and help you set up your child’s first behavioral health treatment appointment.