Benefits

^*Prior authorization rules apply
^**Prior authorization rules may apply

For out-of-Network (OON) services, prior authorization rules apply.

Non-emergency medical transportation is provided through Medical Transportation Management, Inc.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Neighborhood INTEGRITY for Duals Member Handbook.

Neighborhood INTEGRITY for Duals benefits include behavioral health and substance use services. Covered benefits have a $0 copay, coinsurance, or deductible.

We cover both inpatient and outpatient mental health and substance use programs designed to help diagnose and treat your condition.

Services include:

• Day treatment
• Inpatient hospital services
• Outpatient services**
• Intensive Outpatient Program (IOP)
• Substance use residential treatment
• Community Psychiatric Supported Treatment (CPST)
• Methadone maintenance
• Integrated Health Homes (IHH) 
• Mental Health Psychiatric Rehabilitation Residence (MHPRR) 
• Supportive Mental Health Psychiatric Rehabilitative Residence Apartments (MHPRR-A)
• Acute Residential Treatment Services (ARTS)
• Assertive Community Treatment (ACT) 
• Psychiatric rehabilitation day programs
• Opioid Treatment Program (OTP) 
• Partial Hospitalization
• SSTAR Birth Residential Program

For out-of-Network (OON) services, prior authorization rules apply

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Neighborhood INTEGRITY for Duals Member Handbook.

If eligible for Long-Term Services and Supports**, Neighborhood INTEGRITY for Duals provides coverage for:

• Adult day health program
• Homemaker services**
• Skilled nursing services**
• Meals on Wheels
• Assisted Living Facility*
• RIte@Home shared living
• Nursing Home Care*
• Personal Emergency Response (PERS)^*

You may also be interested in the Personal Choice program. This program allows you to be your own boss in hiring personal care assistants** and paying for the services that will help you to stay at home or in the community.

^*Prior authorization rules apply
^**Prior authorization rules may apply

Please note: Members receiving Long Term Services and Supports (LTSS) may have a patient share responsibility. Please contact the Department of Human Services (DHS) Long Term Care Office (LTC) for more information on whether patient share applies to you.

Neighborhood INTEGRITY for Duals also offers members extra benefits* for $0 including:

• Routine Dental Service
• In-home support services*
• A healthy food savings card*
• Over-the-counter (OTC) prescription drugs
• Gym membership and fitness tracker
• Home delivered meals after an inpatient hospitalization or surgery
• Member rewards and incentives

For more information on Neighborhood INTEGRITY for Duals extra benefits, visit www.nhpri.org/medicare-medicaid/INTEGRITYDuals/more-benefits.

No prior authorization is required for supplemental benefits.

^*The benefits mentioned are part of a special supplemental program for the chronically ill. You may qualify for coverage if you have a chronic condition including but not limited to hypertension, diabetes, chronic pulmonary disease, severe hematologic-rare genetic disorders, and depression. Additional eligibility criteria apply. Please contact us for full details.

Please refer to the INTEGRITY for Duals Member Handbook for a complete list of benefits and services.