New Year, New Deductible?

We understand health insurance details can be hard to navigate. Knowing how your insurance works can help you get the mental health care you need without unexpected costs. 

Useful terms:

Deductible: this is the amount you have to pay before insurance starts paying their portion to your providers.  This typically resets on January 1 at the beginning of each year.
​Copay: this is a set amount you pay each time you see your provider after you have fully met your deductible.
Coinsurance: this is a percentage of the service you’re receiving from your provider that you are required to pay after your deductible is fully met.

Cost sharing is a way for you and your insurance company to share the costs of your healthcare. 

Everyone's plan is different, with varying deductible, copay, and coinsurance amounts. To help clarify these concepts, check out these examples:

If your insurance is out of network, this means that the provider(s) are not contracted with your insurance company. You would be responsible for the full fee for services provided, which will be due at the end of your appointment. However, even if you’re out of network, you may have what are called out of network benefits. This means your insurance company may reimburse you a portion or percentage of that visit cost!  As a courtesy, most providers will create a superbill, a detailed invoice of your therapy services, for you to submit to your out of network insurance for potential reimbursement.  Many thanks to www.aspirepsychologyportland.com for this helpful post!

So as the New Year rolls around, make sure you check with your provider on any changes to insurance, deductibles, or copays.  This will help you get the most out of your insurance benefits while also supporting your mental health!

Everyone here at Compass Counseling & Wellness wishes you a healthy and peaceful start to the New Year.