Insurance Basics
Although an effort is made to be best informed about how insurance companies will process your claim, it is not possible to know every patient's policy and benefits. The information below is provided in an attempt to inform you of what you might expect from your insurance company.
DEDUCTIBLES An insurance deductible is a specified amount of money the client must pay before an insurance company will pay a covered service. Deductibles are renewed at the beginning of each plan year.
CO-PAYMENTS A co-payment is a fixed amount payable by the client as determined by the insurance company.
CO-INSURANCE Co-insurance is a certain portion that the client is responsible to pay for services provided and may be in addition to deductibles and co-payments.
IF YOU NEED MORE INFORMATION Due to the vast number of different insurance companies and employer specific plans. It is recommended you speak directly to your insurance company or your Human Resource Department if you have additional questions regarding your insurance coverage.
Questions to ask your insurance provider to determine behavioral health benefits and responsibilities:
Does my health insurance plan include behavioral health benefits? If so, are they managed by another insurance company?
Do I have a deductible for mental health services? If so, what is it and have I met it yet?
Does my plan limit how many sessions per calendar (or plan) year I can have? If so, what is the limit?
Do I need to have written approval from my primary care physician in order for services to be covered?
Is this provider considered In Network or Out of Network with my insurance?
Do I have out-of-network benefits, and, if so, how do I request reimbursement for services?
What is my copay or coinsurance responsibility for In Network and Out of Network services?
