What is Teletherapy and Will My Insurance Accept it?

Teletherapy is an amazing way to receive mental health services for those that are not able to go into an office for therapy. Rising to popularity during the pandemic, virtual therapy has proven over time to be just as effective as in-person work. You may have a very busy work schedule, or your children may have demanding schedules that limit the amount of time you have for yourself. You may have intense anxiety about doctors’ offices or don’t like driving. Whatever the case may be, teletherapy is available and most insurance companies offer standard co-pays or full coverage for telehealth visits. 

Insurance companies have learned over the past few years that many of their customers prefer telehealth services over in-person services. Therapists that are credentialed and accept certain insurances bill services in the same ways as in-office personnel would bill. In both cases, your identity, payment information, and other medical information are still protected by HIPPA laws.

Almost every insurer covers teletherapy the same amount as in-person therapy, including  Aetna, Blue Cross Blue Shield, Cigna, Magellan, and TennCare. In addition, if you have a PPO or POS insurance plan, you can likely receive some reimbursement when you see a provider out-of-network.

Checking Your Particular Insurance Plan

Navigating insurance plans can be challenging and many people do not know where to start. The fastest way to figure out what your insurance plan covers is to contact Member Services phone number on the back of your insurance card. Insurance companies have designated personnel to receive calls and explain in detail what your individual plan covers. If calling on the phone seems stressful, insurance companies also have official websites with commonly asked questions. It can also be helpful to reach out to therapist offices directly to ask if they accept your insurance plan.

Some helpful questions to ask your insurance company include:

1. What is my co-pay for mental health services?
2. Is this provider in-network or out-of-network?
3. If this provider is out-of-network, will there be full reimbursement? 
4. If I use an out-of-network provider, what is the process for getting reimbursed?

Don’t forget: You can ask your insurance provider directly for a list of approved, in-network providers.

What are Common Insurance Challenges?

When pursuing services with your insurance company, there are a few things you want to be sure to resolve. For instance, some insurance companies require pre-authorization to be completed before they will reimburse your therapist. This requires you to get the provider to request the services, document why they are needed, and get approval before proceeding. Another thing to be aware of is the difference between in-network and out-of-network therapists. If you choose an out-of-network therapist, you want to make sure to check the reimbursement rate with your insurance carrier to see the difference in cost.

In addition to these issues, there can be coverage gaps and coverage limitations. First, you want to see if any of these exist and if they do, having a conversation with your insurance carrier will help get your questions answered and the details of how these will affect you.

Tips for Navigating Insurance Coverage

· UNDERSTAND YOUR POLICY.

Take the time to understand your coverage limits, exclusions, and conditions. This will help prevent any unwanted surprises.

· ASK QUESTIONS.

Don’t hesitate to contact your insurance company to get clarification. Keep the phone number handy in a posted place for easy access.

· CONSIDER YOUR DEDUCTIBLE

Evaluate your deductible options when selecting your policy and stay informed about what your deductibles are.

· REGULARLY REVIEW YOUR COVERAGE

Make note of any change notices you are sent by your insurance company, so you have the up-to-date financial information you need.

· KNOW YOUR CLAIMS PROCESS

Staying familiar with your claims process helps you to also keep up with what documentation is going to be required. You can make sure you have the paperwork needed when you are staying informed.

· ADVOCATE FOR TELEMENTAL HEALTH

Many insurance companies have already approved telemental health. If your insurance company does not list it as a service, ask for it. Sometimes insurance companies will approve it. Discuss with them your circumstances and why it better serves your needs. This is a positive way to advocate for your needs.

· SEEK ASSISTANCE FROM YOUR TELEMENTAL HEALTH PROVIDER

Your telemental health provider can often assist with answering questions and direct you to the correct resources to resolve insurance dilemmas.

In Conclusion…

At first glance, it may seem daunting to use your insurance for mental health benefits. In our demanding world, navigating the world of insurance may not be high on your list of “to-dos.” However, spending time on the front end to understand how your insurance policy works and what your coverage is can save time and prevent financial concerns.

Telemental health offers another option that just may fit your world and schedule better than traditional mental health. HopeNation Counseling has skilled therapists that can offer you cutting-edge care. We empower people to remove barriers and pursue help when they need it in the privacy of their own homes. This is becoming a wonderful option for so many in these challenging times.