Questions to Ask Your Insurance Company About Coverage

Does my policy include mental health services?

Will my policy cover treatment for (your symptoms)?

What rate does my policy pay?
(e.g. 80% of usual and customary vs. 80% of billed amount)

Do I need prior authorization from someone in order for coverage to be in effect? Who? Do I need to get a medical necessity letter? If so, do I need to send it prior to acquiring services or can it go in with the first bill?

How many treatment sessions will be covered per year?

Is there a limit on the total amount paid out for mental health services?
(e.g., pay for mental health services only to $1500 in 1 year or 6 months)

Do you pay for out-of-network provider services? If so, at what rate?

What is the licensing requirement of the provider?
(e.g., Psychologist, Counselor)

Would it be helpful to have the session treatment code?
(e.g., 90812: Psychotherapy with other devices)