Using out-of-network insurance benefits
Many insurance plans provide out-of-network mental health benefits, which means you may be able to receive partial reimbursement for therapy services.
If your plan includes these benefits:
• You pay for the session at the time of service
• A detailed session receipt can be provided
• You submit the receipt to your insurance company
• Your insurance provider may reimburse a portion of the session cost
Because every plan is different, it is helpful to contact your insurance provider directly to understand your coverage.
Questions to ask your insurance company
If you plan to use out-of-network benefits, you may want to ask your insurance company the following questions:
• Do I have out-of-network mental health benefits?
• What is my out-of-network deductible?
• How much of the session fee will be reimbursed after my deductible is met?
• Is there a limit to the number of sessions per year?
• Do I need pre-authorization for therapy services?
• What is the procedure for submitting out-of-network claims?
Good Faith Estimate of Expected Charges
You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.