When you need counseling services, finding a good counselor who matches your treatment needs should be your number one priority.
But how do you find a quality provider you can afford?
Since most people use insurance for their counseling services, it is important to understand how to navigate through the complex aspects of insurance plans.
Otherwise, you risk getting started with a counselor only to find out that he or she is not covered by your insurance, or that the cost of services is more than expected.
Therefore, it is important to understand what to ask your insurance provider before scheduling counseling services.
Usually, there is a telephone number on the back of your insurance card, or a website for your insurance company where you can find help.
Here is some information that may help guide you through the process.
- What is “in network” and “out of network”? Some counseling providers have signed a contract with an insurer to be part of the insurance network at an agreed-upon rate. Some insurers provide some limited coverage for services provided by out-of-network providers, while some only cover services from in-network providers.
- What is a deductible? The deductible is the amount you must pay out of pocket for certain services before an insurance plan will pay toward those services. Deductibles typically renew each calendar year.
It is important to ask not only how much your deductible is, but also how much has already been met this year.
- What is a co-payment? This is a fixed amount you pay for a service. Co-payments for specialists such as counseling professionals may be different than for regular primary care physicians.
- What is coinsurance? This is a percentage of the full amount charged by the provider. You pay coinsurance after your deductible has been met.
Not all plans have coinsurance, but it is possible to owe both a co-payment and coinsurance.
- What is prior authorization? Some insurance plans require a request for the service to be covered prior to the use of the service.
- What are session limits? Some plans have a limit on the number of counseling sessions they will cover in a calendar year. Some plans will only cover certain types of services (e.g., individual counseling but not family counseling).
Ensuring that the insurance aspect of your treatment is resolved allows both you and your counselor to move forward with treatment and avoid any unnecessary interruptions in your services.
Alison Jedrick, MSW, LISW-CP, is an associate with Psychological & Counseling Associates of the Lowcountry, LLC in Bluffton.