How to Check Your Insurance for Coverage
Navigating insurance coverage can feel overwhelming, especially when you're considering counseling. Understanding what’s covered can help you make the best decision for your care. Here’s a simple guide to checking your insurance and ensuring you’re ready to begin your journey toward healing.
Vist HelloAlma.com
The insurance companies I partner with are: Aetna, United Healthcare, and Cigna. Visit HelloAlma.com to see if check your insurance provided is listed. Note: not all plans are covered, and visiting HelloAlma is an initial check, you will still need to confirm coverage with your insurance provider.
Workers Compensation
For Workers Compensation (through Pinnacol, etc.) you would get a referral from your physician.
Call Your Insurance Company
To check your insurance for coverage directly, give your insurance provider's customer service a call. The number is typically on the back of your insurance card. Ask them questions about your coverage. This will help you make an informed decision before starting counseling.
Here are some helpful questions to ask the representative:
Do I have out-of-network mental health, or behavioral health, benefits?
What is my out-of-network deductible? Does that include medical? Have I met it?
Are out-of-network services by a licensed professional counselor covered?
What is my co-insurance for out-of-network care?
Is any pre-approval required under any circumstances before obtaining out-of-network mental health services to be reimbursed?
For psychotherapy, ask: Do you cover procedural codes 90834 and/or 90837?
For psychotherapy, ask: What is the maximum allowed amount for procedural codes 90834 and/or 90837? ***FYI Sometimes the representative will say they can’t tell you. This is illegal. You have a right to this information and they must tell you. If they still won’t tell you, then ask them to begin recording the call and request to speak with a supervisor.***
If I have out-of-network benefits, will I be reimbursed the full amount I paid or a percentage? What percentage?
Superbill
If my services are out-of-network and you'd like a Superbill for potential reimbursement, please let me know, and I’d be happy to provide one. Note that I can not in any way guarantee that you will be reimbursed, or the amount of reimbursement from your insurance provider. And you will be responsible for covering any fees the insurance company does not cover.
For more information about Superbills see this article
Related Articles
