Understanding Insurance, Private Pay, and Therapy
Insurance Helps Determine Reimbursement
Health insurance can be an excellent resource and has helped many people access mental health care who otherwise might not have been able to. Like other areas of healthcare, insurance helps cover services that meet the requirements of your individual plan.
Depending on your plan, that may include things like requiring a mental health diagnosis, reimbursing only certain types or lengths of therapy sessions, determining what is considered medically necessary, or limiting how often or how long services are covered. These guidelines are important to understand because they help determine what your insurance will reimburse-but they don’t always determine what type of therapy is the best fit for your unique situation.
We Help Determine the Right Approach
At Family First Therapy, we begin with a different question.
Rather than asking, “What does insurance cover?” we ask, “What approach is most likely to help you reach your goals?”
For one person, that may be traditional weekly therapy. For another, it may be extended 90-minute sessions, outdoor therapy, in-home therapy, or intensive therapy. We believe those decisions are best made collaboratively between you and your therapist based on your goals, circumstances, and what will be most helpful-not solely on what a particular insurance plan reimburses.
If your insurance helps reimburse part of that care, wonderful. We’re happy to help you make use of those benefits whenever possible.
Understand Your Insurance Benefits
While we don’t bill insurance directly, some clients are able to use their out-of-network benefits for reimbursement. If your plan offers out-of-network coverage, we’re happy to provide a superbill that you can submit to your insurance company.
Before getting started, we recommend contacting your insurance provider and asking:
- Do I have out-of-network benefits for outpatient behavioral health services?
- Do I need a referral from my primary care physician?
- What is my out-of-network deductible, and how much of it have I already met?
- After meeting my deductible, what percentage of my sessions will be reimbursed?
- How do I submit out-of-network claims for reimbursement?
If your plan doesn’t offer out-of-network benefits, you may still be able to use a Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for therapy.
Getting Started
If you’re ready to begin, or even just thinking about it, the next step is reaching out.
We’ll help you determine what makes the most sense based on your needs, preferences, and availability.