Understanding Your Insurance Benefits

Insurance coverage can be confusing. You know when you go to the doctor’s office, how you walk into the appointment not having a clue what type of bill you’ll be getting? Thankfully, things are different with counseling.

With just 1 call to your insurance company, you can know exactly what to expect to pay for a typical assessment and therapy session. But what do you ask when you call? What do the terms mean? Let me break each of them down.

Contracted/Negotiated Rate

This is the rate that is agreed upon as the cost for the session when using your insurance.

Deductible

This is the amount you will need to pay before your insurance company will begin paying. If you have a $200 deductible, you will need to pay the full contracted rate each session until you have paid $200. Then your copay or coinsurance will begin.

Copay/Co-insurance

A copay is a set amount you pay each time, typically something like $25.

A co-insurance means you will pay a percentage of the fee. Let’s say the contracted rate is $100 and you have a 10% co-insurance. You would then pay $10 each session (10% of $100).