A Guide To Using Your Health Insurance for Counseling Services
When to Utilize Insurance For Counseling Services
Many people want to utilize their insurance when looking for counseling and therapy services. Often times, this makes perfect economic sense. Yet, there are many times when it is actually financially detrimental to utilize your insurance–but many people have not realized this. Don’t worry, we can help you.
- Blue Cross/ Blue Shield
- Blue Care Network
- Physician’s Health (ASR)
- United Healthcare
- Out of Network Plans
- Beacon Healthcare (Formerly Value Options)
- Blue Cross Complete
- Reliant EAP
- Sliding Scale Available
*The best insurance plans for you usually have a “Copay” for counseling services. This is a small fee that you pay during each counseling visit. A typical fee is anywhere between $20-40 dollars per visit. This is a great benefit for you, because your insurance picks up the rest of the fee for you, and you only owe an affordable copay.
When to NOT use Insurance for Counseling Services
We cannot tell you to NOT use your insurance–but this section has some information on when you may not choose to utilize your insurance coverage. Because the insurance industry is rapidly changing regarding finances, individual and family plans, and applicable laws, many people are confused by their plan. In fact, there are many times when utilizing your insurance benefits for counseling actually offers you no benefit at all. Don’t worry, we can work with you on a “lower cash rate” if using your insurance when does not make economic sense for you. We are flexible!
- Scenario #1: High Deductible Insurance Plan
In this scenario, you do you have “in-network” benefits with our counselors, but you do not have a “copay” required for counseling services. Likely, your insurance company has contracted with the counselors at Health for Life Grand Rapids for their insurance rate, which is $120 per session. In this situation, it may benefit you to pay the deductible rate, because if you eventually meet your deductible (or out of pocket maximum). At this point, your insurance company may pay for some or all of your counseling appointments for the rest of the year. However, if your deductible is very high ($5000 or more)–like many plans–you may never meet your deductible while attending counseling. Don’t worry, we can help! If you like, you do not have to use your insurance for counseling. We can work out a “cash rate” for counseling that works for you. However, if you choose to pay a reduced “cash rate” in this situation–you may not submit receipts to your insurance for reimbursement or apply it to your deductible.
- Scenario #2: An affordable deductible, but there is no copay for counseling.
Some health insurances plans, have a lower deductible of about $2000 dollars–but no copay for counseling. Yet, you are not required to utilize your health insurance for counseling services. Some people only want to come to counseling for 6-10 sessions. And in this situation, at the insurance contracted rate of $120 per session, they will not meet their deductible. So you have the right to not use your insurance and ask about a reduced-cash rate for counseling.
- Scenario #3: I don’t want my insurance company knowing that I see a counselor
While the counselors at Health for Life Grand Rapids will never share your confidential health information. Some people do not want their health information submitted to insurance companies for a variety of reasons. It is your right to not utilize your insurance and work with your counselor on a cash-rate. *The affordable care act made it illegal for health insurance companies to use a “pre-existing condition” against you. However, this may not be the law of the land forever, so you must make a personal decision about your healthcare information and “diagnoses.” We, at Health for Life Grand Rapids, are working to “stop the stigma” against “mental health care” and are working to have the healthcare system and society treat the brain and “mental health care” like they do medicine for all other systems of the body–with respect.
Did you know many insurances will reimburse you for Out of Network services?
While many consumers do not realize this, many insurance plans will actually reimburse you (partial or full) for counseling services that you pay out of pocket for. To find out if you qualify for this service, you must call your health insurance company and ask to speak to someone about “out of network” benefits. From there, they will let you know the method for submitting claims to your health insurance plan. Most of them require an invoice from your healthcare provider. All the clinicians at Health for Life Grand Rapids will be glad to provide you with a monthly invoice, or a cumulative overview invoice. Just ask!
Using your Health Saving Account
Yes! You are allowed to use your Health Saving Account (HSA card), Health Reimbursement Account, and other forms of tax-saving plans with all of the Counselors at Health for Life Grand Rapids (with both in-network and out-of-network coverage). In fact, you may also use Health Saving Accounts with your Naturopathic Doctor and Clinical Hypnotherapist as well. It is up to you how you use your HSA account.