Q. What does my insurance cover?
A. Insurance plans typically cover diagnosable mental health services. This means they cover treatment for conditions that meet criteria for a mental health disorder. Each insurance plan has its own list of conditions they will cover. If you’re unsure, call your insurance provider to ask specifically about mental health coverage. Insurance companies will not guarantee coverage until after a claim is submitted, so again, depending on what is billed for the type of service you received, it may not be covered.
Q. What doesn't my insurance over?
A. Insurance companies will only pay for services related to a specific diagnosis. Be mindful that they often do not cover issues like marital strain, communication problems, family stress, or conflict with children unless they meet the criteria for a diagnosable condition. Typically, there are other services that might be helpful for treatment that are not covered services like parent consultations for minors, administrative requests, or court recommended services.
Q. What can I expect for my first session using insurance?
A. When you first meet with a therapist, they'll conduct an assessment to determine if your symptoms meet criteria for a specific diagnosis. If a diagnosis is warranted, the therapist will submit this to your insurance company to cover the first session. If a diagnosis is not warranted, this will be an out-of-pocket service. Most likely, you will have a copay for your services or a deductible to meet before your plan will cover your services.
Be aware: Once a diagnosis is made, it becomes a permanent part of your health record. This is especially important to consider for minors.
Q. My insurance says I have O.O.N benefits, how do they work?
A. Some insurance plans offer an out-of-network benefit, which means you can choose a provider that is not in-network and still receive partial reimbursement for your sessions. However, you will still need a diagnosis for reimbursement. Out-of-network benefits allow you to select a provider who is the best fit for your needs without being restricted to in-network options. This can be particularly helpful if the available in-network providers don’t specialize in your area of concern or aren’t accepting new patients.
Call your insurance provider to inquire about out-of-network benefits. Understand how much they will reimburse you, what you need in order to to submit your own claim for reimbursement, and whether or not it’s worth considering using your O.O.N benefits.
Q. What are benefits of not using my insurance for therapy?
A. Choosing to pay out-of-pocket for therapy services can offer several advantages. First, it provides more confidentiality as Out-of-pocket services allow for more privacy as your therapy sessions and diagnosis won’t be reported to insurance or included in your health record unless necessary for an emergency or inpatient services. Additionally, there is increased flexibility as you and your therapist can decide the frequency and duration of your sessions without being limited by insurance rules (which may only cover a limited number of sessions each year). Finally, paying out of pocket gives you the freedom to pick the therapist who is the best fit for you without worrying about in-network restrictions.
Q. Who accepts my insurance at Arrowhead Family Systems?
A. We have four providers who currently accept insurance and have availability to take in new clients. Both Michael Piciucco and Gabby Cavale accept the following insurance plans with exceptions to subplans: Blue Cross Blue Shield, United Healthcare, Aetna, Cigna, and Optum. At this time we do not accept AHCCS, Medicare, or Medicaid plans. Both Rachel Muir and Rachael Plyler accept Blue Cross Blue Shield under supervision from Dr. Kimberly Bailey. If you are curious if your specific plan is covered under one of the above, then reach out to [email protected] and we can run an insurance verification check.
A. Insurance plans typically cover diagnosable mental health services. This means they cover treatment for conditions that meet criteria for a mental health disorder. Each insurance plan has its own list of conditions they will cover. If you’re unsure, call your insurance provider to ask specifically about mental health coverage. Insurance companies will not guarantee coverage until after a claim is submitted, so again, depending on what is billed for the type of service you received, it may not be covered.
Q. What doesn't my insurance over?
A. Insurance companies will only pay for services related to a specific diagnosis. Be mindful that they often do not cover issues like marital strain, communication problems, family stress, or conflict with children unless they meet the criteria for a diagnosable condition. Typically, there are other services that might be helpful for treatment that are not covered services like parent consultations for minors, administrative requests, or court recommended services.
Q. What can I expect for my first session using insurance?
A. When you first meet with a therapist, they'll conduct an assessment to determine if your symptoms meet criteria for a specific diagnosis. If a diagnosis is warranted, the therapist will submit this to your insurance company to cover the first session. If a diagnosis is not warranted, this will be an out-of-pocket service. Most likely, you will have a copay for your services or a deductible to meet before your plan will cover your services.
Be aware: Once a diagnosis is made, it becomes a permanent part of your health record. This is especially important to consider for minors.
Q. My insurance says I have O.O.N benefits, how do they work?
A. Some insurance plans offer an out-of-network benefit, which means you can choose a provider that is not in-network and still receive partial reimbursement for your sessions. However, you will still need a diagnosis for reimbursement. Out-of-network benefits allow you to select a provider who is the best fit for your needs without being restricted to in-network options. This can be particularly helpful if the available in-network providers don’t specialize in your area of concern or aren’t accepting new patients.
Call your insurance provider to inquire about out-of-network benefits. Understand how much they will reimburse you, what you need in order to to submit your own claim for reimbursement, and whether or not it’s worth considering using your O.O.N benefits.
Q. What are benefits of not using my insurance for therapy?
A. Choosing to pay out-of-pocket for therapy services can offer several advantages. First, it provides more confidentiality as Out-of-pocket services allow for more privacy as your therapy sessions and diagnosis won’t be reported to insurance or included in your health record unless necessary for an emergency or inpatient services. Additionally, there is increased flexibility as you and your therapist can decide the frequency and duration of your sessions without being limited by insurance rules (which may only cover a limited number of sessions each year). Finally, paying out of pocket gives you the freedom to pick the therapist who is the best fit for you without worrying about in-network restrictions.
Q. Who accepts my insurance at Arrowhead Family Systems?
A. We have four providers who currently accept insurance and have availability to take in new clients. Both Michael Piciucco and Gabby Cavale accept the following insurance plans with exceptions to subplans: Blue Cross Blue Shield, United Healthcare, Aetna, Cigna, and Optum. At this time we do not accept AHCCS, Medicare, or Medicaid plans. Both Rachel Muir and Rachael Plyler accept Blue Cross Blue Shield under supervision from Dr. Kimberly Bailey. If you are curious if your specific plan is covered under one of the above, then reach out to [email protected] and we can run an insurance verification check.
Ultimately, the decision is up to you! We will gladly accept your insurance if we are in network, we just want you to know all the basics so that you can use your insurance confidently.
Want a quick overview of using your insurance for therapy? Click below for a PDF guide to choosing whether using insurance for therapy is best for you!