What to Know About Using Insurance for Therapy

Utilizing insurance for mental health services is often a confusing process, and many people are not sure where to start. Here are some steps and things to know, along with specific questions to ask your insurance company to better understand what will be covered. 

 

1. Find out what insurance you have. 

• Find out what company is carrying your insurance plan. Even if you have Medicaid, an insurance company manages your plan (e.g. Anthem, Aetna, etc.). 

• You will need your insurance Member ID number to begin therapy, which is on your card. If you do not have your card, you can call your insurance company and ask for your information and a new card. 

• If you are not the primary person on your insurance, you will likely need the primary’s personal information (address, DOB, etc.) for billing purposes. 

 

Questions to ask the insurance company

• I am a member and I do not have my card. Would you tell me my Member ID number?

• Would you send me a new card?

• Is it possible to receive a digital copy of my card today?
   

2. Find out what your insurance will cover

This is the part that feels tricky for people to navigate because so much depends on their specific coverage plan.

• If you have private insurance, you may have to reach your deductible before your insurance company will pay for therapy. Your deductible is a certain dollar amount set for your plan that you have to pay out of pocket for the year before sessions will be covered. 

• In some cases, plans will require you to pay a copay for sessions. A copay is what you will pay out of pocket for the session, and your insurance will cover the rest of the bill. This amount varies greatly depending on the plan. 

• Most Virginia Medicaid plans cover therapy fully, but it is a good idea to call and ask for details of your plan.

 

It can be difficult to find this information when reading through your plan details, and in many cases it is most beneficial to call your insurance company to find out more.

 

Questions to ask the insurance company

• I am starting mental health therapy, and I would like to know what my plan covers for in-network individual therapy. 

• What dates does my plan start and end? 

• Do I need to reach my deductible before sessions are covered OR will I have to pay a copay?

• If deductible: How much is the deductible? Will sessions be covered fully if the deductible is met? 

• If copay: How much is my copay?

• Is there a cap on the number of sessions this plan covers annually? 

 

3. Find a provider who accepts your insurance.

• We strive to take many types of insurance plans at ATP in order to increase access for everyone. Different clinicians at ATP accept different types of insurance based on licensure and contracts with insurance companies.

• It is very common and welcomed to talk to our administrative assistant about who accepts your insurance. Read more about each of our clinicians here to find a good fit for you. You can inquire about ATP services through our online form or via phone. Our office assistant will be back in touch with you ASAP.