Finding and connecting to mental health or substance use services can be challenging for many reasons. One major source of confusion is figuring out the insurance piece. Will my insurance cover appointments? How many appointments? How much will I have to pay for each session? Does my insurance cover inpatient stays? Different plans provide different coverage, so it’s important to understand your benefits ahead of time.
Helpful questions to ask your insurance provider
For an outpatient (office) appointment:
Call the number on the back of your insurance card and ask about behavioral health coverage for Colorado.
- What are my insurance benefits for an outpatient therapy appointment? Do I have a copay?
- Do I have to meet a deductible before using these benefits? If so, how much will insurance pay after the deductible?
- What is my deductible?
- Does [name of potential therapist] take my insurance?
- Does my plan have out-of-network benefits? If so, what does this look like?
For inpatient services:
Call the number on the back of your card and ask about inpatient mental health or substance use coverage.
- What are my insurance benefits for an inpatient treatment stay?
- Do I have to meet a deductible before using these benefits? If so, how much will insurance pay after the deductible?
- What is my deductible?
- What are my out-of-network benefits?
- Do I need preauthorization, and if so, how do I obtain this?
- Can you send a list of inpatient facilities you contract with?
Before you engage in services, you’ll want to know the answers to these questions. Some providers and agencies will verify insurance for you before your first appointment or before you start treatment. However, knowing your coverage information ahead of time can help guide your decision-making.
Many employers offer mental health benefits through Employee Assistance Programs. This typically gives an employee 3 to 6 free sessions with a therapist. If you are unsure if your employer provides this benefit, check with your human resources or finance department.
Understanding your benefits and knowing what to do with that information can feel overwhelming. If you’d like help navigating local behavioral health resources, give Connections a call at 970-221-5551. While Connections staff are not experts on insurance, they can offer assistance and some basic education. If you have questions about your specific plan, please consult with your human resources department or call your insurance company directly.