Finding a therapist can be challenging, especially when you want to use your insurance benefits to pay for therapy.
We’re setting out to make this process a little easier by filling you in on everything you need to know about using Neighborhood Health Plan to pay for therapy. If you have Neighborhood Health Plan insurance, read on to learn all the details.
Does Neighborhood Health Plan cover therapy?
Yes, in many cases Neighborhood Health Plan does cover therapy. However, the exact details depend on what kind of insurance you have with Neighborhood Health Plan.
For example, if you have a Medicare or Medicaid plan with Neighborhood Health Plan, then you’re fully covered for outpatient mental health services.
If you have a different kind of plan with Neighborhood Health Plan, then it’s best to check your summary of benefits to find out exactly which mental health conditions and kinds of treatment your plan covers.
How much does therapy cost with a Neighborhood Health Plan plan?
The cost of therapy will vary depending on two important factors: A) your specific plan’s benefits, and B) whether or not you’re seeing an in-network therapist.
About your plan’s benefits
There are two key things you’ll need to know to determine your payment per therapy session:
- Deductible: The sum total of medical costs you need to pay each year before your insurance coverage begins. (All your medical costs contribute to this, not just therapy costs.) If you haven’t yet met your deductible for the year, then your insurance usually will not cover therapy sessions, and you will be responsible for the full cost.
- Coinsurance: The set fee you pay at every therapy session, after your deductible is met. This typically ranges from $15 to $50 per session.
About in-network therapists
An in-network therapist is one who already has an arrangement to work with your insurance company.
- If your therapist is in-network, then you will have to pay coinsurance or make payments toward your deductible (see the info on this above). The final cost for an in-network therapist depends on your specific plan.
- If your therapist is out-of-network, then you will have to pay the whole fee the therapist charges up front (or the sliding scale rate, if you’ve agreed on this rate with your therapist.) You may be able to get reimbursed a portion of out-of-network costs by using out-of-network benefits.
To find out more about your deductible, coinsurance rates, or out-of-network benefits, check your summary of benefits or contact Neighborhood Health Plan directly for more information.
What types of therapy does Neighborhood Health Plan cover?
Depending on the specifics of your plan, Neighborhood Health Plan may cover a number of different types of psychotherapy. Most plans include both behavioral health treatment and substance use treatment.
To find out more about what kinds of therapy your plan includes, it’s usually best to contact Neighborhood Health Plan directly for more information. Additionally, you should always double-check that your therapist accepts your insurance plan before beginning sessions.
What kinds of therapy does Neighborhood Health Plan not cover?
Like most insurance plans, it is not typical for Neighborhood Health Plan to cover the following kinds of therapy:
- Couples counseling (see below for more info and ways to pay for couples counseling)
- Life coaching
- Career coaching
- Therapy sessions occurring outside the therapy office (for example, an exposure therapy session that involves going outdoors)
What conditions does Neighborhood Health Plan cover?
Again, the only way to know for sure which mental health conditions your specific plan covers is to check your plan benefits or to contact Neighborhood Health Plan directly for more information.
That said, common mental health conditions that Neighborhood Health Plan covers often include:
Note that therapists are required to assign you a diagnosis for the above conditions, and to share that diagnosis with your health insurance, if you are using insurance benefits to pay for therapy.
If you don’t want your insurance company (or family members, if you have a shared plan) to have access to this information about your mental health, consider out-of-network options instead.
Does Neighborhood Health Plan cover couples counseling?
No, not in most cases. While it depends on your specific plan, it is unlikely that Neighborhood Health Plan will cover couples counseling.
That said, even if your specific plan doesn't directly cover couples counseling, you still have options for getting affordable couples counseling. Here are five ways to pay for couples counseling if it’s not included in your health insurance plan.
Do I need to see my doctor before visiting a Neighborhood Health Plan therapist?
Yes, since Neighborhood Health Plan is an HMO, you are typically required to see your primary care physician for a referral to therapy before your insurance company will provide outpatient coverage.
If you do not get a referral, you may want to call your member services number directly to check whether pre-authorization is required for coverage. You can contact member services online or call the number on the back of your insurance card.
How can I find therapists who accept Neighborhood Health Plan?
You can find therapists who accept Neighborhood Health Plan on Zencare.
Find Neighborhood Health Plan therapists near you
Find Neighborhood Health Plan therapists on Zencare, below.
Search by filters like location, availability, and specialties; watch therapist introductory videos; and book free initial calls to find the right therapist for you: