It's Open Enrollment time

Posted by Michala Gallup on Nov 26, 2018 1:11:42 PM

Hi! Michala Gallup here, Office Administrator for Wellspring Renewal Center. You might hear from me if you call in or request an appointment online. However, scheduling for four therapists is only one of my many talents. I also am responsible for filing and making sure you get the most out of your health insurance coverage. [We currently have therapists who accept Ambetter, Blue Cross/Blue Shield, Health Advantage, TrueBlue, BC/BS FEP, Cigna, and QualChoice.] We understand that finances are and will continue to be a major stressor in life and we highly recommend that you use health insurance if you have it and/or that you look toward some better options for health insurance next year. It IS Open Enrollment time and if you buy your insurance through the government's Health Insurance Marketplace then you have until December 15th to apply for and pick an insurance plan for 2019. If you are blessed to have insurance through your employer it is also time to start looking ahead at next year's plans. Either way, as you are shopping or evaluating which plan is the best for you and your family we encourage you to pay specific attention to the policy's MENTAL HEALTH coverage! Here are some things to look for when choosing a health insurance plan that will benefit you and your family's overall health for 2019.

First and foremost, check to see if your policy has mental health coverage. Then whether that coverage requires a co-pay or co-insurance per office visit. Some policies have slightly higher premiums that allow you to have a co-pay for MENTAL HEALTH instead of co-insurance. You can usually find this out by looking at the "Other Medical Services" or "Mental/Behavioral Health" line of the policy that you are looking at. What is the difference between co-pay and co-insurance? Well, a policy with co-insurance requires that you meet ALL of your deductible BEFORE it starts paying for any visits with your therapist. EXAMPLE: we see several Blue Cross/Blue Shield policies with a $1000 to $2000 (plus) deductible then a 20% to 40% co-insurance for mental health. That means that you will be paying $150 for each session until you meet your $1000 (plus)??? deductible. In this example, if you only come once a month you would be paying $150 for each session until around July when your co-insurance would kick in and you would only be paying the typical 20% or $30 for your hour long session. But if you have a $2000 (plus) deductible your insurance benefit will never kick in just coming to counseling once a month. HOWEVER there are policies where Mental Health visits are covered like a typical doctor's appointment and have a $0-$50 co-pay. With a policy that has a co-pay you can see your therapist as many times as you wish to and only pay the flat $30, or whatever your co-pay happens to be. Caution as sometimes there ARE limits on these policies; we sometimes will see a 30 annual visit limit on co-pay policies.

Tip number Two, pay attention on that aforementioned "Mental/Behavior Health" policy line if the mental health coverage is farmed out to a third party. You might have Blue Cross Blue Shield for health insurance, but if the policy you select uses a different provider for their mental health coverage you are going to have a harder time finding a therapist who will accept it. While we are in-network with several providers many of these third party mental health coverage providers are not locally accepted by many of our therapists. (We do accept and are in-network with New Directions.)

Tip number three, see if a HSA, or Health Saving Account, policy is right for you. Some employers offer HSA policies that they contribute a certain amount of money into monthly. On these plans you also have the option of contributing some of your income TAX FREE directly into an HSA bank account that you can use for ANY health related expense including counseling.

Tip four, ask your Human Resource person/team about E.A.P.s or Employee Assistance Program. This is mental health coverage that most people who work for larger companies don't know that they have until they ask. These businesses have thought ahead and have seperate mental health options for their employees in the form of EAPs (4-10 FREE sessions annually with a counselor.) You will have to set these up individually by calling the EAP provider directly. Here at Wellspring we accept EAP's from Aetna, Cigna, Curalinc, Methodist Healthcare, the Presbytery of Arkansas, and are more than happy to see if it is possible for us to join your provider.

Remember from now until December 15th it is VERY important that you do some self care and look ahead at how your health insurance for 2019 will affect your mental wellbeing. Ask, dig and discover what the benefits are for counseling on your policy. Make your mental health an option and priority for yourself in 2019!!!!

 

Topics: Self Care

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