Keep in mind that using your insurance can have unplanned consequences. When you submit a claim for reimbursement, your insurance company requires that the medical necessity of your care is substantiated. Your diagnosis and the supporting evidence for that diagnosis become part of your health record.
If you choose to use your health insurance to cover the cost of counseling sessions, here are some questions to ask your insurance company before you come to your first session.
- Does my plan cover counseling sessions?
- How many sessions does my plan cover in a year? How many sessions do I have left?
- Does my plan cover services to out-of-network mental health providers?
- What is the deductible I have to meet before coverage to an out-of-network provider kicks in?
- What is my copay or what percentage of treatment do I pay when seeing an out-of-network mental health provider?
- Is there a maximum amount per session the insurance will cover for an out-of-network provider?
- How much time do I have to file a claim for out-of-network services?
- Do I need pre-authorization or a referral from my PCP to see a counselor?
- If I need pre-authorization, do I need to call or does my counselor?
- What is the process to get reimbursed for out-of-network services?
- Is there particular form? (if so, have them send it to you)
- When does it need to be filed (after how many sessions)?
- Where does the form need to be sent?