Questions for Your Insurance Company

 

To find out more about your mental health coverage, call your insurance provider before your first session with me.  Be sure to get the name of the person you’re speaking to, and ask the following questions:

 

• Do I have mental health insurance benefits?

• Is approval required from my primary care physician?

• Is pre-authorization required?  What is the name and number of the person to be contacted?

• Are there limitations on which therapists I can see?

• Does my policy cover out-of-network outpatient psychotherapy for me?  For my child?

• Is there a limit to the number of visits allowed?

• What is my deductible and has it been met yet for this calendar year? (The deductible is the amount you must pay before your insurance starts paying.)  If not, how much do I have left to meet?

• What date does my insurance year start over at?

• How many sessions per calendar year does my health insurance cover?

• What percentage of my therapy bills will my policy cover?

• What is my co-pay for each session if out-of-network providers are covered?

• How much will I be reimbursed (%) if I pay out of pocket?

• How do I request reimbursement?

• What is the address of the office where I should send my claims?

• To whose attention is the claim to be sent?

• Is there a special form I will need to send with the bill from my therapist?

• If you want marriage/couple’s counseling, you will need to ask if that is covered by your policy.  Marriage counseling is often not covered, as it is not considered “medically necessary.”

• Finally, ask what company the person you are talking with represents.
   Insurance is quite complex and sometimes the company that pays for mental health care is not the same as the one that pays for your physical health care.