Summary Plan Description
Neuropsychological or Psychological Assessments or Tests—80%
Services and Supplies Must Be Preauthorized With the
Trust Office
Benefits are provided for neuropsychological
or psychological assessments and tests required
to prescribe an appropriate treatment plan
with a lifetime maximum of $1,200. If expenses
exceed the $1,200 lifetime maximum, this
plan will not pay the additional costs. The
lifetime maximum applies to services received
under the Employee Health Plan and the
Retiree Health Plan. These services always
require 20 percent coinsurance and these
coinsurance expenses do not apply toward
the $2,300 annual coinsurance maximum.
This includes any later reevaluations to make
certain the treatment is achieving the desired
results.
Neuropsychological or psychological assessments or tests include the administration and interpretation of tests including, but not limited to, the cognitive function of the central nervous system, Minnesota Multiphasic Inventory (MMPI), the Rorschach (inkblot) test, and developmental testing.
Benefits are not provided for:
- State-required medical assessments for specialized educational programs; services or supplies required by law to be provided by any school system; or treatment for learning disabilities. This exclusion applies regardless of the recommendation of the attending physician.
- Neurological and psychological testing or evaluations related to rehabilitation, neurodevelopmental therapy, cognitive therapy, dementia, or for a change in the patient's environment or residence.
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