Insurance can be CONFUSING!!!!! It is always best to contact your member services representative before a medical, dental or mental health visit. Check your coverage carefully and make sure you understand their answers. I will do my best to help you understand your benefits.
Consider contacting your insurance company's mental health benefits representative to find out the following:
Do you have mental health benefits? Are therapy sessions covered at 100% or partially covered?
Do you have a deductable? Is it met?
Do you have a copay or a cost share even after you have met your deductable? A copay is a set amount for each visit. A cost share is a percentage your insurance company pays for your procedure.
How many therapy sessions does your plan cover?
Is approval required from your primary care physician? (This is rare but, does happen!)
This way there are no surprises!!
What If I do not participate with your Insurance?
For many of you, it feels imperative that the therapist of your choice is in-network with your particular insurance plan. I would like to suggest, however, that there may be other options.
Finding the 'right fit' with a therapist is critical and the most important part of the therapeutic experience. This includes, for example, a mutually available time for meetings, geographical location, gender preference, etc. But most importantly, it includes a potential client's feeling that the therapist be a good fit stylistically and clinically.
But, what if the therapist that seems 'right' for you is not on your insurance plan?
One option is to find out if your plan has out-of-network benefits. This means that you have the option of going outside of your network and be reimbursed a percentage of the fee after your deductible has been satisfied. Each plan is completely different, so the specifics will have to be obtained from your insurance company. Oftentimes the therapist may be able to contact your insurance company to obtain this information for you.
People do not realize that the cost to them when utilizing their out-of-network benefits may end up being similar to remaining in-network. The advantage to going outside of your network is having the ability to select a therapist from a large pool of professionals based on your most important criteria, rather than having to choose someone just because they are in-network with your insurance company.
***Your insurance company sets the allowable amount they will pay for a given service.**
**Fees are discounted for those paying Private Pay. Please see the "Advantages of Paying Private Pay" tab.**
Cash, check and all major credit cards accepted for payment.
If you do not show up for your scheduled therapy appointment, and you have not notified us at least 24 hours in advance, you will be required to pay $30.00 prior to rescheduling.