Should I Use My Insurance Benefits?

You pay a lot for your insurance coverage, so why wouldn’t you want to use them for mental health treatment? There are several things to consider before you use insurance benefits: 

  • Using your insurance benefits requires communication between your provider and insurance company. This includes access to any notes in your medical chart*, diagnoses, and medications.
  • Certain life insurances may not underwrite individuals with a history of mental health diagnoses such as depression or bipolar disorder. If this impacts you, consider doing more research before making a decision on using insurance. 
  • Insurances make determinations about what is “medically necessary,” which preclude certain forms of therapy or alternative medicine, as well as dictating length of treatment (number of sessions).
  • Some people seek therapy to gain insight or psychological understanding. These individuals may not have a diagnosable mental health disorder, in which case therapy will not be covered by insurance. 

Many clients have out-of-network coverage and receive full or partial reimbursement. If you do decide to use your insurance benefits, Talking Twenties can provide you with a statement to help you get reimbursement from your insurance company. This is called a superbill, which is essentially a receipt including the diagnosis and visit type. To know how much reimbursement you can anticipate, call your health insurance. You’ll want to know about:
If you have out-of-network benefits.
What is your deductible (the amount you have to pay before your insurance starts covering services. You’ll also want to know what percentage of fees will be covered after you meet your deductible.
If there is a limit to the number of visits you can have (usually therapy).
How you submit a claim for out-of-network reimbursement.
So you know how much reimbursement to anticipate for each visit, ask about the following visit types specifically:
– A diagnostic evaluation or intake appointment (code 99204)
– Follow-up medication management (codes 99213 and 99214)
– If you’re planning on receiving therapy alone, ask about code 90837. For medication and therapy combined ask about codes 99213+90836 or 99214+90836.

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