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| If you plan on using insurance to help supplement the cost of therapy, you will want to know the answers to these questions prior to meeting with any therapist for the first session:
may not have a deductible. If you do have one, how much it is will vary according to the type of coverage you have. If you have sought medical treatment prior to initiating counseling/psychotherapy service, your deductible may have already been met. Typically you would remember this because you would have likely paid a large amount out of pocket ($250 or greater) either during one doctor's visit, or cumulatively over the course of a few visits during the calendar year. Depending on your insurance company, your coverage for behavioral health may be different than your medical insurance. If you have a deductible and it has not been met prior to attending therapy, you will have to pay out-of-pocket until this amount, as determined by your policy, is reached.
unless you receive counseling/psychotherapy from the clinical professionals appointed by your insurance company. If you have a PPO your insurance will pay for some of the therapists total fees. The insurance company determines a "customary rate" and will reimburse you a portion (potentially as much as 50-75%) of that rate. You are responsible for the percent that your insurance company does not pay, plus the difference between the "customary rate" and the therapist's fee. You can meet with whomever you would like. Professionals who are considered in the insurance company's "network" are reimbursed at a higher rate than those not. It's usually good to find out what percent and the "customary rate" prior to meeting with a therapist for the first time for your own budgeting and planning. Also, you may be surprised to find out that your insurance reimburses more than you thought for an out-of-network provider. If you are not sure or do not see an acronym on your card you may have a plan that is a combination of the two (or something a little different). If this is the case it is best to call the insurance company to determine how much of the cost will be covered.
over the phone, you can download (or request) a claim form. After you get this form, you may want to bring it into session to discuss. For example if you have Federal Blue Cross and Blue Shield, you would do the following: 1. Download and complete the claim form: Federal Employees Care First BC/BS Claim Form 2. Mail the form with a copy of your receipt (verifying payment) to:
P.O. Box 14113 Lexington, KY 40512-4113 |
| Karen E. Eberwein, PsyD Clinical Psychologist 1616 18th St, NW, Ste112, Washington, DC 20009 202-409-7774 |
Using Insurance