Understanding your insurance coverage can help clarify what’s included and what you may be responsible for financially. I share the questions below because having clear, upfront information often leads to fewer surprises and more space to focus on the work that matters. You don’t need to have all of this figured out before reaching out. This is simply a guide if you’d like to explore your benefits in advance.

Understanding Your Insurance Benefits

IN-NETWORK BENEFITS

  • What’s my deductible for in-network mental health benefits?

  • Is there a limit on sessions my plan will cover per year?

    • If Yes, How many?

  • Does my policy cover 60 minute sessions?

    • If yes, how many?

  • How much is my co-payment for mental health services?

  • What is the policy year (i.e. Jan 1 – Dec 31)?

  • Does my plan require pre-authorization for psychotherapy?

  • Do I have out-of-network mental health benefits?

OUT-Of-NETWORK BENEFITS

  • Does my 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 my co-insurance percentage for mental health services?

  • Does my plan require pre-authorization for psychotherapy?

  • What is the policy year (i.e. Jan 1 – Dec 31)?

  • Does my plan require a referral for psychotherapy?

  • What is the reasonable and customary fee for my county?

“Reasonable and customary fee” refers to the amount your insurance company considers the typical range for services in a given geographic area.

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