About insurance companies benefits

Someone recently emailed and asked about how to understand insurance benefits, and what to expect to pay.  This is a very common question, so I thought I'd post my response:

Each insurance policy is different.  Usually you will get better benefits if you see someone in-network, however some out-of-network benefits are quite good especially if you have met your deductible.  Some insurance companies manage mental health benefits, and may require your therapist to provide clinical information after they have seen you. You can call your insurance company and ask them to tell you about your outpatient mental health benefits. 

 

Your insurance company should provide this information for both your in-network and out-of-network benefits:

deductible (and what amount has been met, year to date),

 

copayment or coinsurance amount per session,

 

limit in number of sessions per year (if you work for a company that has more than 50 employees you should have unlimited sessions per the Mental Health Parity Act), and

 

whether they cover the modality (individual, family, couple {frequently not covered}, or group) of therapy you are seeking.

 

Once you have this information, you can talk with a therapist and they should be able to help you anticipate what your session fee would be.

 

Hope this helps - feel free to ask other questions in the comments section, or call me if you have more questions.

 

Peace, Lisa Catania, LCSW
773-719-1751