Navigating Insurance
Understanding your coverage shouldn’t be overwhelming. Here’s how to ask the right questions, make sense of superbills, and confidently use your mental health benefits.
Key Questions to Ask Your Insurance Provider
- Coverage for therapy
- Does my plan cover therapy services (mental health or behavioral health)?
- Deductibles, copays, coinsurance, and session limits
- What is my deductible for mental health services?
- What is the copay or coinsurance per session?
- How many sessions are covered per year?
- Prior authorization and referrals
- Do I need prior authorization or a referral to see a therapist?
- How do I get authorization or a referral if required?
- Telehealth coverage
- Are teletherapy or online sessions covered?
- Are there restrictions or different costs for telehealth?
- Out-of-pocket maximums
- What is my out-of-pocket maximum for mental health services?
- After I meet it, are therapy sessions fully covered?
- Diagnosis requirement
- Does my plan require a formal diagnosis for therapy coverage?
- Out-of-network providers
- Does my plan cover out-of-network therapists?
- What is the reimbursement rate for out-of-network services?
- How do I submit a claim for out-of-network therapy?
- Superbills and reimbursement
- How do I submit a superbill for out-of-network reimbursement?
- What information must be on the superbill?
- Session limits and treatment duration
- Is there a limit to how many sessions I can have?
- How is length of treatment decided?
- Specialized services
- Does my plan cover EMDR, trauma therapy, or group therapy?