3 Key Tips for Navigating Your Mental Health Insurance Benefits

1. Know what your deductible is. When you log into your member benefits website, look for "deductible." This is the amount you are expected to pay out of pocket for care that may not be routine. Often the deductible is waived for mental health (also called behavioral health). When in doubt, call the member number on the back of your card and ask if your deductible applies to mental health, meaning whether you can start counseling without first satisfying a $6,000 deductible, for example.
2. Find out what your copay is. That is the amount you pay before or after each counseling session while your insurance company pays the rest. Copays can range from $0 to $20 or more depending on your plan. Again, when in doubt, call the member number on the back of your card. Your insurance company considers you their member, so you are part of the benefit plan family and have more rights than your provider or counselor does.
3. Look for your co-insurance on your benefits page. This is often not a flat rate. It is the percentage of the session cost that you share with your insurance company. For example, you might pay 20% of a $160 session and insurance pays the other 80%. So your co-insurance (your part of the bill) would be $32 per session, and your insurance would pay the provider the remaining $128. You will not usually have both a copay and co-insurance. Again, if this is confusing, or you want to prevent surprises later, call the number on the back of your insurance card.

I hope this was helpful. If you are looking to start services with me, I, with the support of my billing team, will help you understand your deductible, copay and co-insurance. We can also contact your insurance company together.

~Peace & Love,
Sarita