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Mental Health Insurance: Questions to Ask
Some information borrowed from The George Washington University

 

Prior to scheduling an appointment with a therapist, it is important for you to contact your insurance company and find out what they will pay for and what your financial responsibilities will be. The questions below will help you to gather important information about your mental health insurance benefits, which will assist you with making informed decisions about therapy.

  • Does my plan cover mental health outpatient visits?
  • Do I have to see someone on the provider list?
  • If yes, where can I get a copy of the provider list for providers in my area?
  • Is there anything I need to do to have my counseling sessions covered by insurance, if I am living out of state?
  • How does my coverage differ if I see a participating provider versus a provider "outside of network"?
  • For how many sessions can I be seen?
  • What is the percentage co-pay for sessions?
  • Do I have a deductible that I have to satisfy? If yes, how much?
  • Is there a pre-existing conditions clause for my plan? If yes, what is the length of time I have to wait prior to my insurance covering a pre-existing problem?
  • What is the effective date of the plan?
  • Do I have to fill out any paperwork to be pre-certified prior to seeing a therapist?

If you will be submitting claims:

  • What information will you need from my therapist in order for my claims to be paid?
  • Where do I send my claims?
  • Approximately how long does it take to receive reimbursement?

When you contact therapists, ask them if they are accepting clients who are insured by your insurance plan. Also find out if they will require you to pay for sessions when you are seen or if they will bill your insurance company.

 

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