It sometimes seems like a no-brainer to utilize health insurance for therapy, but please keep in mind the following when utilizing health insurance:
-The visits have to be determined to be "medically necessary" for the insurance company to pay their portion. This requires a diagnosis code and can require clinicians to submit documents or reports that demonstrate services were obtained. If a claim is rejected for any reason, you become responsible for the full payment.
- Some people have high deductibles and it would take many sessions before your insurance company would start to pay. For example, if your insurance company contracts therapy at $125/session but you have a $3,000 deductible, it would take you 24 sessions to meet your deductible if other medical expenses did not contribute to the deductible, and you would pay the $3,000 up front before you only have to pay your copay.
Health insurance can be confusing for many people and I like my clients to be as informed as possible about covered services and out of pocket expenses prior to their first appointment. This necessitates some leg work on your end but can make the process go much more smoothly without unexpected charges occurring.
Important things to do before your initial appointment:
I. Contact your insurance company listed on the back of your health insurance card. Give them my name and make sure that I am showing up as an in-network provider. You can still work with me if you have out of network benefits, but you will also pay more out of pocket.
II. Understanding your deductible. It is your responsibility to know what your deductible is and how much you have already contributed toward meeting it. A higher deductible will mean that you have to pay more out of pocket expenses upfront before your copay kicks in. Some companies may waive deductibles altogether for mental health, allowing you to simply pay your copay. Please note that insurance companies reimburse at different rates and that by contracting with them, I agree to accept the rate they charge, even if my fee is higher. The staff at Very Well Health explain these concepts pretty well and you can read more about it below.