What Insurance Do I Have? Understanding Health Insurance for Therapy
When beginning the process of signing up for therapy, understanding your health insurance and its benefits can be one of the most daunting obstacles. However, your insurance doesn’t have to stand in the way of getting the mental health support you need.
At Aspire Psychology, our team of experts is here to walk you through each step of the intake process, including navigating your insurance plan.
If you’re new to understanding health insurance and how it applies to mental health care, check out our guide to Health Insurance 101.
What Insurance Plans Does Aspire Psychology Accept?
At Aspire Psychology, we accept commercial plans through Kaiser, Pacific Source, Regence/BCBS, and Aetna. We cannot accept Medicare or Medicaid/OHP as a primary insurance.
How Do I Manage Multiple Insurance Plans?
If you are covered by more than one health insurance plan, such as through both your own employer and a partner’s, you may be unsure how to best apply your insurance for therapy.
Patients covered by more than one insurance plan are required to notify all carriers. This process is known as Coordination of Benefits (COB).
Who Pays First?
Insurance companies use COB rules to determine which plan is “primary” (and thus pays first) and which is “secondary” or “tertiary.”
Why Does It Matter?
If insurance carriers are unaware of other coverage, they may deny or delay your claims, leaving you responsible for the full bill.
When beginning therapy, contact the member services number on the back of your insurance cards to verify that your COB status is up to date with all active insurance plans.
Does Aspire Accept Secondary Coverage?
If you have a commercial plan as your primary and Medicare/Medicaid as your secondary coverage, a waiver is required. Because we cannot bill government payers for reimbursements, you will be liable for any cost-shares applied by your primary commercial insurer.
Cost-shares may include:
Deductibles
Coinsurance
Copays
Can I Use Out-of-Network Commercial Insurance?
If your commercial insurance plan is not in-network, you can choose to “private pay” for your sessions. We will provide you with a superbill, which you can submit to your insurance company for potential reimbursement.
Can I Use My HSA and FSA Accounts at Aspire?
Yes, you can use your Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) at Aspire Psychology, but note that these accounts have high deductibles. Many patients choose to keep their HSA/FSA card on file so the practice can automatically process deductibles or copays at the time of service.
Can I Pay Out of Pocket if I Have OHP or Medicaid?
Unfortunately, if you have OHP or Medicaid as your primary insurance plan, you are not able to pay out of pocket for services at Aspire.
Does My Plan Cover Medication Management Services?
Certain plans may or may not cover medication management services: for example, most Kaiser plans require a prior authorization before granting coverage. At Aspire, we’re happy to work with you to determine whether or not your insurance plan covers medication management.
Don’t Let Health Insurance Confusion Stand In the Way of Mental Health Treatment
At Aspire Psychology, we’re committed to helping you get expert mental health care in Portland, Oregon. If you’re struggling to understand your health insurance benefits, contact us today to learn more. Our administrative team is happy to come alongside you as you begin your treatment journey.
