Information for existing clients when New Year approaches
This is a quick reminder that there are often insurance changes at the beginning of each year. If you changed your insurance during open enrollment, please make sure that your new/current insurance information is in your profile, including front and back pictures of your new insurance card. If your insurance stayed the same, but you got a new insurance card (new number and/or new expiration date), please also upload pictures of your new card to your profile.
Whether your insurance changed or stayed the same, annual deductibles often reset on January 1 each year (for plans with a deductible). For anyone who may be new to this insurance stuff, that means that insurance will charge you for the full session cost, not just your copay or coinsurance, until you have met (paid up to the amount of) your deductible. In good news, insurance discounts the fee we charge, so you still get a savings through your insurance.
IF YOU ARE SEEING A SUPERVISEE OF SOCIAL WORK OR RESIDENT COUNSELOR, please be aware of how insurance billing works for them. Insurance does NOT allow Supervisees or Residents to submit sessions under their own name/ID. Only licensed therapists (like an LCSW, LPC, or LMFT) can bill insurance. However, a few insurance companies let Supervisees or Residents bill under their supervisor’s name and ID, because the supervisor is ultimately responsible for ensuring the level of care the Supervisee/Resident is providing.
WHAT THIS MEANS FOR YOU. If you are seeing a Supervisee or Resident and using insurance, your sessions are billed to insurance at the Supervisor’s rate (eg. $150 for a 55-minute session). The private pay rate for the Supervisees/Residents ($75 per session) is only for private pay sessions.
After people have met their annual deductible, this can be a tremendous savings (since you only pay your copay/coinsurance after that). However, before you meet your deductible, it can cost MORE to use insurance than to do private pay. (Sorry, we don’t make the insurance rules – we find this all very complicated and frustrating, too!)
You have a couple of options.
1) You are welcome to continue having your sessions billed to insurance. This will cost more initially, but will help you meet your deductible faster. (Again, for our new-to-insurance clients, there is not a separate deductible for mental health versus medical costs – your therapy sessions count toward your deductible, just like any doctor visits, etc.).
2) If you prefer, you can switch to private pay ($75 per session out-of-pocket). You can keep private pay in place all year, or switch back to insurance after your deductible is met.
(Please note that private pay sessions with a Supervisee/Resident CANNOT be submitted for reimbursement to your insurance, so will not count toward your deductible. But you CAN submit for reimbursement from an FSA, or pay with your HSA.)
FOR ALL CLIENTS, INCLUDING CLIENTS SEEING A LICENSED THERAPIST: If you need to reduce the frequency of your sessions until after you’ve met your deductible (ex. go down from weekly to every other week), that is absolutely an option. Please contact your therapist to discuss your schedule. We don’t want your therapy costs to be a source of stress.
Sorry this was so long, but insurance can be complicated (right?), so there was a lot to cover. If you have any questions about any of this, or anything related to costs or billing, please email us at billing@allofyoucounseling.com.