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  • Ashley Hughes, PMHNP-FNP
  • Becky Royston, LCSW
  • Jennifer Stevens, LCMHCA
  • Amy Young, LCSW
  • Tools To Help Find Your Way

Resources and Road Maps​

New Year, New Deductible?

1/3/2025

 
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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:
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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.

Preparing for Insurance Open Enrollment Focus on Mental Health

7/30/2024

 
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It's almost that time of year again..... the questions about whether your chosen insurance will cover your ongoing or new services can be stressful.  The providers at Compass Counseling & Wellness want you to benefit from your insurance coverage as much as possible.  Here are a few tips to help with this process:

Our providers are individual owners, and therefore in-network contracts may differ based on your provider.  Check each page to verify if your insurance is in-network for your provider.

Once you have that information, take these questions with you and contact your insurance company PRIOR to your first appointment to be informed about your financial responsibility for services.

For In-network benefits, ask these questions:
  • What’s my deductible for in-network mental health benefits?
  • Is there a limit on sessions your plan will cover per year?
    • If Yes, How many?
  • Does my policy cover 60 minute sessions?
    • If yes, how many?
  • How much is your co-payment for mental health services?
  • What is the policy year (i.e. Jan 1 – Dec 31)?
  • Does your plan require pre-authorization for psychotherapy?
  • Do I have out-of-network mental health benefits ?

For Out-of-network benefits, ask these questions:
  • Does your plan include “out-of-network” coverage for mental health?
  • Is there an annual deductible for out-of-network mental health benefits?
    • If so, how much?
  • Is there a limit on the number of sessions your plan will cover per year?
    • If Yes, How many?
  • Is there a limit on out of pocket expenses per year?
  • What is your co-insurance percentage for mental health services?
  • Does your plan require pre-authorization for psychotherapy?
  • What is the policy year (i.e. Jan 1 – Dec 31)?
  • Does your plan require a referral for psychotherapy?

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  • Home
  • Jenna Daley, LCSW
  • Dr. Pholile Dlamini, PsyD, HSP
  • Kara Ewing, LCSW
  • Jennifer Hammett, LCMHC
  • Jessica Henkel, LCSW
  • Ashley Hughes, PMHNP-FNP
  • Becky Royston, LCSW
  • Jennifer Stevens, LCMHCA
  • Amy Young, LCSW
  • Tools To Help Find Your Way