Often people come in with insurance and are unfamiliar with their benefits and what they may be responsible to pay. We want to give you some terminology and briefly cover what you might expect. Keep in mind that insurance vary from company to company and plan to plan. We have listed the top pieces of information that you might need.
In Network vs Out of network:
We have and continue to work to be credentialed on the most common insurance panels of people in the Permian Basin. Often we may have limited providers on a particular panel for a number of reasons. For example, the provider may be new and working on getting credentialed, or the insurance company is not taking new providers. Case in point, Cigna has not opened up for new providers in over two years. Strangely enough, there are occasions when we are credentialed with an insurance without our knowledge. If you have a question about whether one of our providers is in network for your insurance plan, talk with your insurance.
Deductibles, Copays, and Coinsurance:
Be aware that in the beginning of your insurance plan’s fiscal year that you may have a new deductible. Some Insurance plans begin their new year in September, but most begin in January coinciding with the calendar year. The deductible is the out of pocket costs that you pay until your deductible is met. This can vary from no deductible to $5,000 or more. This means you are responsible to pay the entire allowable amount billed to insurance.
Copays and insurance differ in that a copay is a set cost. You may have a co-pay of $20, $35 or $50 for each visit, regardless of the length of the visit (usually 45 minutes or 60 minutes). A coinsurance amount is usually a percentage of the allowable billed amount. They may be as low as 15% or up to 50% or more. Both copay and Coinsurance can vary according to your therapist being in network or out of network. (Out of network often costs you more).
Insurances that we (at least one of our therapists) are credentialed with:
- Blue Cross Blue Shield of Texas
- United Behavioral Health
- Texas Medicaid