Guide to Out-of-Network Benefits

Fortunately, depending on your health insurance plan, your insurance company may help reimburse a portion of the cost by mailing you a check. If you have a PPO or POS health insurance plan, you'll get partial reimbursement for out-of-network services, making therapy more cost effective and budget friendly. Though navigating out-of-network benefits can be cumbersome, it can save some money in the long run. Please use the following steps to learn how they work.

Check your out-of-network benefits

These are typically in the Summary of Benefits, included in a member information packet or on your insurance company website.

Call your insurance company to verify your benefits

The best way to be absolutely sure of your benefits is to clarify with your insurance company member services line. You can find the contact information on the back of your insurance card or through your online insurance platform.

Ask these questions when speaking to your insurance company about benefits:

• How much of my deductible has been met this year?

• What is my out-of-network deductible for outpatient mental health? (Outpatient means outside a hospital)

• What is my out-of-network coinsurance for outpatient mental health?

• Do I need a referral from an in-network provider to see someone out-of-network?

• How do I submit claim forms for reimbursement? (Claims are forms that are sent to your insurance company to receive reimbursement for sessions you paid for out of pocket)

There are beneficial reasons to see an out-of network therapist. By following these steps, you'll be able to expand your search and make the most of your insurance.