Got to love insurance right?! Insurance can be both a blessing and a curse. I remember in the past when insurance was simpler, cheaper and easier to navigate. Whenever I saw a doctor or did anything medically I just paid my $10 co-pay and that was it. It was amazing!
Fast forward 12 years and insurance has transformed into a big ball of complexity. There are things like Deductibles, Coinsurance, In and Out of Network Providers and Tele-therapy. Sad thing is that these complexities tend to turn people away from getting the much need help they need within the Mental Health world. And, understandably so! But, it doesn't have to be. Here are 5 brief definitions to untangle the complexities of insurance in order to help you move forward with counseling (just remember every insurance is different so please verify with your particular plan.)
Deductibles: A deductible is the amount you pay for mental health services before your health insurance begins to pay. How it works: If your plan’s deductible is $3,000, you’ll pay 100 percent of eligible health care expenses until the bills total $3,000. After that, you share the cost with your plan by paying coinsurance. Some health insurance plans provide some benefits before you meet the deductible but it all depends on the plan.
Coinsurance: Coinsurance is your payment of a therapy session. It's usually figured as a percentage of the amount you are charged for services. You start paying coinsurance after you've paid your plan's deductible. How it works: You’ve paid $3,000 in health care expenses and met your deductible. When you see your therapist, instead of paying all costs, you and your plan share the cost. For example, your plan pays 70 percent. The 30 percent you pay is your coinsurance.
In-Network: In-network counselors have contracted with your insurance company to accept certain negotiated (i.e., discounted) rates. You will typically pay less with an in-network provider. How it works: You see your in-network counselor with a total charge of $110. A discount of $75 is applied to that amount and then you'll pay the remainder $35.
Out-of-Network: An out-of-network provider is what Traveling Light Counseling is considered, as we are not contracted with any insurance companies. Depending on your health plan it will determine what reimbursement if any you will receive from your insurance. Some health plans, do not reimburse at all. Other health plans offer coverage for out-of-network providers, and your responsibility varies. I have clients that have seen me and have only paid $31.00 per 50-minute session and the insurance takes care of the rest. Other clients have to meet their deductible prior to the insurance kicking in and paying the full amount or a large percentage. It really all depends on your insurance carrier and your plan. Reasons for choosing an out-of-network provider may be necessary, just make sense or even advisable depending on the situation. Some scenarios in which you may want to choose an out-of-network provider are for specialized care, proximity issues, availability of good care and someone that you have a therapeutic alliance with.
Tele-therapy: Tele-therapy allows a counselor at Traveling Light Counseling to give online therapy to a client from the comfort of their home. It is the same standards of service you would receive from in person therapy but via a secure HIPPA compliant video system. How it works: Clients just click a link to start—no logins, no passwords, no hassle. Have a session from anywhere, on any device.
Co-Pay: A copay is a fixed amount you pay for a health care service, usually when you receive the service. The amount can vary by the type of service and the type of insurance plan you choose. How it works: Your plan determines what your copay is and if you have one for counseling services. You may have a copay before you’ve finished paying toward your deductible. You may also have a copay after you pay your deductible, and when you owe coinsurance.
Don't let the complexities of insurance hold you back from getting the mental health treatment you, your family or your marriage needs. Your worth the extra steps needed to get services in place. Some of the benefits of Counseling include:
Gain greater self-confidence
Impove your relationships
Regain emotional balance
Set healthy boundaries
Get perspective and clarity
The insurance world is everchanging. If you do not want to use your health insurance and are limited in what you can afford, there are options that I would love to discuss with you either during our 15-minute phone consultation or in our initial session. There are a variety of ways to think about the purpose and process of therapy as it is a unique journey for each individual/family. Please consider all the pros and cons as it pertains to you, your family and the current season of life that you’re in. Only you can make the decision.
Traveling Light Counseling is in the heart of Port Saint Lucie and easily assessable from Vero Beach and Martin County due to our close proximity to US1 and the Turnpike. I am committed to the process of helping you find hope and healing and I look forward to getting started with you at your first appointment. Please do not hesitate to contact me with any questions or concerns you may have. We very much welcome and appreciate new clients into our practice, so we can help them achieve the goals that matter to them most.