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Mental Health Insurance Coverage
Mental Health Insurance Coverage
Common Health Insurance Provider “Find a Doctor” Websites:
*On most websites, the student will have to enter insurance information found on the student’s health insurance card. When searching for a counselor, psychologist, or psychiatrists, the student will likely need to select to search for a “Behavioral Health” provider (as opposed to medical, dental or hospital).*
United Healthcare/ United Behavioral Health (*GW student health insurance company*): https://www.lww-trans.com/clinicianSearch.laww?id=88888&lang=1
Blue Cross Blue Shield: http://www.bcbs.com/healthtravel/finder.html
Aetna: http://www.aetna.com/docfind/home.do?site_id=docfind&langpref=en&this_page=enter_welcome.jsp
Kaiser Permanente: http://www.geoaccess.com/Kaiser/po/KaiserIntro.asp
Cigna: https://apps.cignabehavioral.com/web/acref/PMRSController?cat=initial
Working with your Insurance Provider
1. Know Your Insurance Plan
a. You are not required to use your insurance to pay for private care, but most people do. Keep in mind that you are responsible for paying any fees you incur that are not paid by your insurance.
b. If you have the United Healthcare insurance plan, you must be referred by the UCC or Student Health Services in order to waive your deductible when paying an off-campus provider. This referral can be completed by asking for a Referral Authorization Form from either a counselor or the Case Manager at the UCC, or from Student Health Services (SHS).
c. If you have some other insurance policy, determine your policy's requirements by contacting your insurer directly. If you are on your parents' plan, you may have to speak with your parents to gain access to your insurance. Your UCC counselor can help you think through how to have such a conversation with your parents, or s/he can speak to your parents for you (with your written permission).
2. Work with your insurance company
a. You will need to work directly with your insurance company and your off-campus provider to file insurance claims. Every insurance policy is different, so you must take responsibility for finding out how your insurance policy works. Policies differ in terms of which providers you can see or how often, whether a referral is required, the amount of your coverage, etc.
b. Good ways to find out about your insurance policy include calling your insurance company on the phone, looking them up on the Web, or reviewing your policy brochure.
3. Determine what your insurance will pay and what you are responsible for.
a. Prior to scheduling an appointment with a therapist it is important for you to contact your insurance company and find out what they will pay for and what your financial responsibilities will be. The questions below will help you to gather important information about your mental health insurance benefits, which will assist you with making informed decisions about therapy.
- Does my plan cover mental health outpatient visits?
- Do I have to see someone on the provider list?
- Is there anything I need to do to have my counseling sessions covered by insurance, if I am living out of state?
- How does my coverage differ if I see a participating provider versus a provider "outside the network"?
- For how many sessions can I be seen?
- What is the percentage co-pay for sessions?
- Do I have a deductible that I have to satisfy? If yes, how much?
- Is there a pre-existing conditions clause for my plan? If yes, what is the length of time I have to wait prior to my insurance covering a pre-existing problem?
- Is my plan currently active? If not, when will it be activated?
- Do I have to fill out any paperwork or be pre-certified prior to seeing a therapist?
If you will be submitting claims:
- What information will you need from my therapist in order for my claims to be paid?
- Where do I send my claims?
- Approximately how long does it take to receive a reimbursement?
4. Learn the Insurance Terminology
a. Claim - the request submitted to your insurance company by either you or your provider, asking them to help pay for the services you receive. Some policies require that the provider submit the claim and be reimbursed directly by the insurance company; other policies require that you pay your provider and then submit a claim.
b. Deductible - the amount you must pay out-of-pocket before your insurance company will begin to help cover your bills. For example, if your policy has a $100 deductible, you must pay the first $100 of the fees you incur for that insurance year.
c. Co-pay - the amount you pay for a service in addition to whatever your insurance company pays. For example, your insurance company may require that you co-pay a certain amount (e.g., $20) or a certain percentage (e.g., 20% of the bill) per visit, while the company pays the rest.
d. Benefits - the types of services and costs that your insurance policy covers. For example, some policies have no outpatient mental health benefits, or require a referral/approval in advance, or have a "cap" or upper limit of payment, or require that you use only their "preferred" providers. You must determine the benefits of your policy by contacting your insurance company or by reading your policy carefully.
5. Additional information about your health insurance
a. Information about the United Healthcare student insurance plan, including all covered benefits, is available at www.uhcsr.com.
b. Information about other insurance companies can be found on their websites, accessible through the links at the top of this page.
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