Insurance
Focus Forward Counseling and Consulting, Inc. accepts virtually all major insurance plans. If your insurance doesn’t cover the requested service or if you choose not to utilize your insurance we offer affordable rates to make counseling, therapy, and psychological evaluations accessible.
Accepted Insurance Providers
At Focus Forward Counseling and Consulting, we accept insurance plans from the following carriers.
Aetna – A subsidiary of CVS Health, Aetna offers individual and family health insurance plans as well as behavioral health, dental, disability, long-term care and pharmaceutical plans. These plans are generally provided through employer paid insurance and benefit programs as well as through Medicare.
Anthem – The largest for-profit managed healthcare company in the Blue Cross Blue Shield (BCBS) Association, Anthem is a trusted health insurance plan provider. Anthem also offers insurance plans for medical, dental, vision, life, disability and more. Plans are available through employer group plans, Medicare, individual and family insurance plans as well as Medicaid and state sponsored programs.
Cigna – Evernorth – A global health service company, Cigna – Evernorth offers medical, dental, pharmacy, accident, life, supplemental and Medicare plans to individuals, families and businesses. Cigna’s motto as an insurance carrier is to help you improve your health, wellbeing and peace of mind.
Humana – The third largest health insurance company in the nation, Humana is a for-profit health insurance company based in Louisville, KY. Humana believes healthcare plans should help with more than paying medical bills, which is why their focus is on not only supporting physical health but emotional and social health as well.
United Health Care (UHC), United Behavioral Health (UBH) & Optum – The second largest healthcare company following CVS Health, UnitedHealth Group offers commercial group insurance plans across the US under various product names. UHC offers individual, family, employer and Medicare-Medicaid health insurance plans. Optum is part of the UnitedHealth Group and is a pharmacy benefit manager and care services group.
Medicare – A national health insurance program under the Social Security Administration, Medicare is administered by the Centers for Medicare and Medicaid Services (CMS). Medicare insurance is for those 65 and older and anyone with disability status according to the Social Security Administration.
Insurance Information
Should I use insurance? Will my confidentiality be protected?
There are costs and benefits of using mental health insurance. The main benefit is that it can be helpful at times in terms of limiting your out of pocket expenses. There are also significant limitations to be mindful of. One is that your mental health diagnosis will be saved in your insurance records and it is difficult to predict how this will affect your future insurability and premium costs. In addition, your privacy is limited as insurance companies have the right to review your clinical records if they choose to. Some individuals prefer that this information be kept completely confidential between client and therapist. If you would like to learn more about fee for service options, click here.
Verification of Benefits
Mental health insurance policies can be challenging to understand. At Focus Forward we’re happy to help you sort through the information and will contact your insurance provider on your behalf to verify your insurance coverage. In the meantime, the following information lists some frequently asked questions related to mental health coverage.
In a typical mental health plan, how many visits are covered?
Mental health plans can vary dramatically. Most plans allow unlimited visits without the need for authorization for routine outpatient services; psychological testing typically requires preauthorization.
What will my plan cover?
Most insurance companies reimburse based on medical necessity; this means that they will cover mental illnesses but they tend to have more restrictive coverage options for everyday problems of living such as grief and loss, couples and marriage counseling, career counseling, and general relationship matters. In other words, this can be a good news/bad news situation in which healthy individuals (the good news) with important concerns get denied coverage (bad news) due to not being mentally ill.
Can I see a therapist of my choosing?
If you have a Health Maintenance Organization (HMO) plan or a prepaid health plan, you may choose from a limited pool of health care professionals. These professionals are in-network providers, and it may not be possible to see a therapist of your choice. With a Point of Service (POS) plan (also known as a Fee for Service plan), you can see any doctor in the country, and your insurance company will assist in the coverage of your fees. Preferred Provider Organization (PPO) plans tend to be the most flexible, allowing you to meet with both in and out of network providers. For a full description of these plans, see the glossary below.
Will I need a referral from my primary care physician?
Typically no, but because some insurance companies do require a referral from a primary care physician be sure to inquire before you start your search for a therapist.
Glossary of Plans
Deductible plans
These plans are similar to traditional health care plans, in which insurance companies pay for the services you receive as a policyholder. You pay a premium—a monthly fee—and in turn you may choose any doctor you wish and visit any hospital for services. The deductible is a certain amount of money that you must spend on health care each year before the insurance kicks in. After you have spent that amount, you share payments with your insurance company based on a percentage (for example, you pay 20 percent of the session fee and the insurer pays 80 percent). While the up front cost can appear intimidating at times, many of these plans are actually quite reasonable with extended care.
HMO
Health maintenance organizations contribute to the cost of mental health care. Your choice of health care providers and facilities is limited. This group of professionals is called a network. In an HMO, you may be assigned a primary care physician, who will refer you to specialists in the network. You will be required to pay a co-payment for each visit.
POS
Point-of-service is an HMO-based plan that also allows for out-of-network visits. To use in-network providers you must have a primary care physician. A POS plan is a regional plan. Members can use services outside the HMO area, but they must reside inside the HMO area to be eligible for coverage.
PPO
A preferred provider organization combines a fee-for-service plan with an HMO. The result is national insurance coverage in which you may choose from providers on a “preferred” list and pay lower costs. You are also typically able to meet with non-network providers.