Not sure about Does your insurance cover mental therapy and how much it cost? Let’s dive into Insurance 101. Don’t worry, we’ll make it as entertaining and concise as possible.
Premium Package: Does My Insurance Cover Mental Therapy All?
First, we have the premium. It’s like the monthly fee you pay (or your employer pays, or both) to your insurance company. Think of it as your membership dues to keep the insurance going.
Copays or Coinsurance Insurance
Next, copays or coinsurance. Copay is a fixed rate you pay (e.g., $20) for services, regardless of the provider’s rate. Your insurance usually takes care of the rest. Coinsurance, on the other hand, is a percentage of the provider’s fee that you pay (e.g., 20%), while your insurance covers the remaining 80%. These are set by your insurance company, not therapists.
But wait, there’s more, Nowadays, many plans come with a deductible. It’s the amount you have to pay out of pocket before your insurance kicks in (with some exceptions for preventive care and therapy—check your plan details). Until you hit that deductible amount, you’re responsible for the full provider’s fee. Once you cross that threshold, your copays or coinsurance rates come to the rescue.
IN NETWORK vs. OUT OF NETWORK
Insurance companies have a panel of providers they’ve contracted with, setting specific rates called “contracted rates” or “reimbursement rates.” In-network providers have agreed to these rates, so your out-of-pocket costs are usually lower but not always. Out-of-network providers don’t have a contract, so their rates aren’t adjusted, but your plan may still offer some coverage. (Zane Counseling is in-network with Premera, Aetna, Cigna, and Lifewise, if you have one of these insurance plans we will bill them directly)
Remember, in-network billing might require a diagnosis and gives your insurance more control over your therapy process. Out-of-network providers offer more independence, but it varies from plan to plan.
Will Superbills Insurance Cover Therapy?
Some therapists offer superbills. A superbill is a magical document that some therapists provide for out-of-network therapy that helps you get reimbursed by your insurance company for out-of-pocket costs from out-of-network care. Here at Zane Counseling, we provide superbills if you request them. (This happens when we work with clients who have Regence, United, Kaiser, etc, companies we are not in-network with).
Your plan likely has an out of pocket max for the year. Once you hit that limit which your insurance cover therapy, regardless of in-network or out-of-network providers. It’s like unlocking the ultimate reward—financial peace of mind!
Also, You can use your HSA or FSA account to pay for copays, coinsurance, and deductibles.
This guide only scratches the surface of insurance policies and is not a guarantee of coverage. Insurance is complex, but armed with some knowledge, you can bravely navigate the system. At Zane Counseling, we’re committed to providing clarity upfront, so there are no surprises when it comes to costs. Transparency is our jam!
If you’re interested in therapy and want to use your insurance, but unsure where to start reach out to us at firstname.lastname@example.org and we will help you!
Remember, understanding your insurance can transform the way you seek support—without fearing the bill. Stay empowered, my friends!