Kristin Moore, LCSW, Licensed psychotherapist

Thinking Through the Insurance Maze

If possible, it is good to use your insurance, but it is not always possible. The person you want to work with might not be in your provider netowrk or you might not have any insurance. What to do?

An explanation about health insurance, especially about terminology: Health insurance policies can allow you to use any service provider of your choice ("out of network") or may restrict you to a list of providers ("panel") that they approve ("in network").

I have primarily chosen to be independent of insurance company panels because I do not want to be subject to managed care restrictions. However, I did register as a provider in the Magnacare network—though that does not work for all plans that use the Magnacare network.

If your health insurance policy allows out-of-network coverage, the company might reimburse some part of the fees for psychotherapy, then there would only be a co-pay due. To simplify the process, my office submits the insurance forms and payment is made. GHI is a special case: I work with GHI, but I am not an in-network provider. However, I submit the paperwork to GHI as if in-network, and arrange a co-pay with the client that is comparable to standard.

To find out, call your insurance company and ask:

  1. what your out-of-network mental health benefits are,
  2. the amount of your deductible,
  3. the percentage or dollar amount of your reimbursement, and
  4. the number of sessions per year to which you are entitled.

If you have in-network-only coverage or very limited coverage, you could certainly text, call, or email me to see what we can do to make therapy affordable.