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RATES AND INSURANCE
A COMPREHENSIVE GUIDE TO COST FOR TREATMENT
The Support & Guidance You Deserve
The following resources are to support overall well-being and physical health. The resources are intended to complement, not replace, professional medical advice on your plans benefits.
Methods of Payment
All major credit cards are accepted as forms of payment.
Cancellation Policy
If you cannot attend a session, please cancel at least 24 hours beforehand. Otherwise, you are charged $60 for a no-show fee.
Current Insurance Accepted:
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Aetna
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Ambetter
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Blue Care Network(BCN)
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Blue Cross Blue Shield
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Cigna/Evernorth
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Medicaid
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Medicare
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Medicare-Railroad
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McLaren Health Plan
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Meridian Complete
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Meridian Health Plan
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Molina Healthcare
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Priority Health
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Tricare
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UnitedHealthcare
Please contact us for any additional questions you may have. We look forward to hearing from you!
UNDERSTANDING INSURANCE PLANS
01
Explanation Of Premiums And Copays
Premiums and copays are two different costs that are part of having health insurance and health care.
A premium is an amount you pay to your insurance company each month to have insurance. For example, when you buy car insurance, you pay the insurance company each month, and health insurance is the same. If you don't pay your health insurance premium, your health insurance will be cancelled.
A copay (short for copayment) is a set amount of money you have to pay each time you need medical care—for example, if you see a doctor, get lab tests, or go to the hospital. Different plans have different copays. Some have no copay at all, while in some cases you may have to pay $10 or $25. For lab visits, other tests, emergency room visits or hospital stays there will be other copays.
When you choose which insurance plan you want to buy, part of your choice is about whether you want low or high monthly premiums and copays. Each person or family decides what plan is best for them based on how often they think they will need medical care.
02
Explanation of Deductibles and Co-Insurance
Deductibles
Some insurance plans have a deductible. This is a set amount of money that you must pay before the insurance company starts to pay for certain services. When you have a high deductible, your health insurance premium (your monthly bill for health insurance) is often smaller. Some people choose a high deductible if they think they will not need much medical care because their monthly payments are lower.
Once you reach your annual deductible, your insurance company may pay for a more significant part of your healthcare costs. Co-insurance: Depending on your insurance plan, your insurance might only pay a percentage or a part of your health care cost. For example, if your insurance pays 80% of the x-ray costs, and your x-ray is $100, your insurance will pay $80, and you will pay $20. Some people pay more for their monthly premiums so they have lower or no co-insurance costs.
03
Explanation of Out of Network Coverage
When you sign up with a health insurance company, it is recommended that you see health care providers in that insurance company's network. That means those healthcare providers accept your insurance plan. If you want health care outside that network, you may have to pay for it. That is why, if you already have a doctor, hospital or another medical provider that you want to use, you should make sure they are in a health insurance company's network before you choose that insurance plan.
Some insurance plans will allow you to see an out-of-network provider by paying more for the appointment, but it is up to you to check if your doctor receives your insurance.
04
H.M.O. (Health Maintenace Organization) And EPO (Exclusive Provider Organization)
Premiums and copays are two different costs that are part of having health insurance and health care. A premium is an amount you pay to your insurance company each month to have insurance. For example, when you buy car insurance, you pay the insurance company each month, and health insurance is the same. If you don't pay your health insurance premium, your health insurance will be cancelled.
A copay (short for copayment) is a set amount of money you have to pay each time you need medical care—for example, if you see a doctor, get lab tests, or go to the hospital. Different plans have different copays. Some have no copay at all, while in some cases you may have to pay $10 or $25. For lab visits, other tests, emergency room visits or hospital stays there will be other copays.
When you choose which insurance plan you want to buy, part of your choice is about whether you want low or high monthly premiums and copays. Each person or family decides what plan is best for them based on how often they think they will need medical care.
05
P.P.O. (Preferred Provider Organization) And P.O.S. (Point-Of-Service Plan)
With these plans, you can choose any doctor or hospital. It will cost less if you pick ones that are part of the insurance plan's network.
With P.P.O. plans, you can visit any doctor without getting a referral. If you have a P.O.S. plan, you can visit any doctor without a referral, but doctors outside the plan do need a referral.
06
HDHP (High Deductible Health Plan)
HDHPs usually have low premiums and high deductibles compared to other plans. With an HDHP, you can use a health savings account or a health reimbursement arrangement to pay for some medical costs.
Your employer takes some of your paychecks and puts them into a particular savings account. When you need money for medical care, you can take it from that account.
CENTERS FOR MEDICARE ACT aka CMS
No Surprises Act ("Good Faith Estimate")
You have the right to receive a "Good Faith Estimate" explaining how much your care will cost.
Under the law, healthcare providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.
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You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. Related costs include medical tests, prescription drugs, equipment, and hospital fees.
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You may obtain a reasonable faith estimate upon request before scheduling an initial appointment and/or before scheduling an item or service. *It is challenging and sometimes impossible to estimate how many appointments you will need until your concerns are evaluated.
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You are free to discontinue services at any time. Additionally, the provider may terminate services as outlined in the informed consent document.
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Fees are listed in the informed consent and will remain in effect for 12 months unless otherwise stated. *A service fee schedule is included below.
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If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
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Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.
Different Health Insurance Plans offered for Coverage
There are different types of programs that people can be eligible for. Many people receive health insurance through their job as a benefit. Depending on their company, they may pay a small monthly cost for their insurance or no cost at all. Other people receive Medicaid, which is insurance from the State. Other health insurance programs, like Medicare for seniors age 65 or older. The Children's Health Insurance Program (CHIP), is specifically for children. These programs have special requirements. People who do not get insurance through their job, Medicaid, Medicare, or CHIP have options to buy independently at a reasonable rate.
Updates to Health Insurance Standards
The A.C.A. changed how health insurance works. Some of the changes are:
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Parents can keep their children on their health insurance plans until they turn 26 years old.
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Insurance companies cannot turn down people with medical conditions, sometimes called "pre-existing conditions". Before, a company could decide not to insure someone because they had a medical condition like diabetes or because they had cancer in the past. Now, everyone must be accepted.
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Insurance companies cannot cancel an individual's insurance plans if they get sick.
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Insurance companies cannot limit how many medical bills they will pay for someone on their insurance plan.
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Preventive care is now free. Your insurance cannot charge you for baby doctor visits, vaccinations, annual checkups, screenings, and other care that helps you stay healthy.
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You can buy your insurance in the Health Insurance Marketplace (Marketplace). Before, if your job did not offer you health insurance, you had to buy it on your own, which was usually costly.
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Health insurance plans now have to cover a certain amount of care. Before, each company decided what it would pay and for what amount.
Out of Pocket
The necessary documentation will be available for you to access any out-of-network benefits. When contacting your insurance company to inquire about out-of-network benefits, you will need to ask specifically about reimbursement for the following:
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C.P.T. code 90791 (initial session)
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C.P.T. code 90834 (45-minute follow-up)
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C.P.T. code 90837 (50-minute follow-up)
For specific out-of-network benefits, please contact your insurance carrier.
Out of Pocket fee:
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$160 per individual per 50-minute session.
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$175 for family/couples per 50-minute session.
Depending on your current health insurance provider or employee benefit plan, services can be covered in whole or part. Please contact your provider to verify how your plan compensates you for psychotherapy services.
I would recommend asking these questions to your insurance provider to help determine your benefits:
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Does my health insurance plan include mental health benefits?
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Do I have a deductible? If so, what is it, and have I met it yet?
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Does my plan limit how many sessions per calendar year I can have? If so, what is the limit?
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Do I need written approval from my primary care physician for services to be covered?
Rates for Services
Psychiatric Psychotherapy
Individual Psychotherapy 14 & UP ($180 per hour)
Uncover unconscious thoughts and feelings through traditional talk therapy.
Family Therapy ($200 per hour)
Help your family members improve community and resolve conflicts.
Telehealth Therapy ($180 per hour)
Receive therapy through an online video call.
Group Therapy ($85 per hour)
Discuss and resolve problems together as a group.
Life Coaching ($150 per hour)
Identify your biggest goals and develop an actionable plan to achieve them.
Life Coaching & Community Advocacy
School Outreach Services ($150 per hour)
Provide brief counseling to students/staff for educational institutions that experience a traumatic event.
Community Restoration Consulting-Homeless Prevention (Price Determined upon consultation)
Assist local government with the creation of new programming that addresses diversity, systemic issues of homelessness, and behavioral health.
Social Worker Supervision Services ($110.00/hour or $2,800.00 PKG)
Get social worker supervision outside of an agency if you are a recent graduate with a Master of Social Work degree. Includes clinical case conceptualization, clinical case conferencing, ASWB exam preparation, training on implementing therapeutic modalities, and professional development.
Agency/Company Contracted Social Worker Supervision Services ($110.00/hour or $2,800.00 PKG). Get social worker supervision for your agency interns or provisional social workers.
