Networks change. We verify your specific Carelon (formerly Beacon) plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: Carelon Behavioral Health, Carelon, Beacon Health Options, Beacon.
Carelon Behavioral Health is the managed behavioral health company of Elevance Health, formerly known as Beacon Health Options and before that Value Options. It administers mental health and substance use benefits for Anthem and other Blue plans in some states, for employer groups, for Medicaid managed care plans, and for government programs. If your card lists Carelon or Beacon for behavioral health, Carelon maintains the psychiatry network, processes authorizations and pays claims, while your cost sharing follows your underlying plan. Outpatient psychiatry generally requires no referral or authorization. Telehealth psychiatry is covered at parity for members in Florida and South Carolina.
Carelon applies its own clinical criteria for interventional treatments. Transcranial magnetic stimulation is covered for major depressive disorder when you have failed at least two antidepressants from different classes at adequate dose and duration, have engaged in psychotherapy, and have a documented severity score; prior authorization is required and initial approvals cover a standard course with continuation based on measured improvement. Spravato is typically authorized through Carelon or the underlying plan's pharmacy benefit, with requirements of treatment-resistant depression, a concurrent oral antidepressant and REMS-certified administration. Some older cards still say Beacon; the benefits are the same. Stedfast Psychiatry staff work with Carelon's provider portal and confirm the correct authorizing party for each patient.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
My card says Beacon Health Options. Is that the same as Carelon?
Yes. Beacon Health Options became Carelon Behavioral Health in 2023 as part of Elevance Health's rebranding. Your benefits, network and phone numbers generally carried over. If your card still shows Beacon, the behavioral health number on the back will reach Carelon, and Stedfast staff can verify your benefits either way.
Is Stedfast Psychiatry in network with Carelon?
Stedfast Psychiatry works with Carelon Behavioral Health for many of the commercial, Medicaid and employer plans it administers in Florida and South Carolina. Network participation can vary by contract, so confirm through Carelon's member line or ask our front desk to run an eligibility check before you schedule.
Does Carelon cover telehealth psychiatry?
Yes. Carelon-administered plans cover video visits for psychiatric evaluation, medication management and therapy at the same benefit level as office visits for members located in Florida or South Carolina during the appointment. Your copay or coinsurance is set by your underlying medical plan rather than by Carelon.
How does Carelon handle TMS authorization?
Carelon requires prior authorization for TMS and reviews requests against its clinical criteria for major depressive disorder, including failure of at least two antidepressants, a psychotherapy trial and a current severity score. Our Palm Beach Gardens TMS team submits the documentation through Carelon's provider portal and follows up until approval.
Does Carelon cover Spravato?
Spravato is covered with prior authorization for treatment-resistant depression when you are taking an oral antidepressant and receive treatment at a certified clinic. Depending on your plan, Carelon or the medical plan's pharmacy benefit issues the authorization. We identify the correct party, submit the request and coordinate drug supply at our Spravato offices.