Using insurance for counseling, explained plainly

Plans Brett sees

• Employer plans (Choice, Choice Plus, Options PPO, Navigate)
• Individual and family plans
• UnitedHealthcare Community Plan (Medicaid) and Medicare Advantage vary by product; ask on the call

On your card

Look for "UnitedHealthcare" on the front and, often, "Optum" or "United Behavioral Health" for mental health on the back.

Four questions for the number on your card

1. 1.Call the member services number on the back of your card and ask for behavioral health benefits.
2. 2.Ask: is Brett C. Larsen, LPCC-S, in network for outpatient mental health visits under my plan?
3. 3.Ask what you pay per visit: a copay, or coinsurance after a deductible, and how much of the deductible is left.
4. 4.Ask whether video visits are covered the same as office visits.

Video sessions: UnitedHealthcare generally covers video counseling with an in-network provider the same way it covers an office visit. Confirm for your plan.

Plans Brett sees

• Behavioral health for UnitedHealthcare commercial plans
• Employer behavioral health carve-outs administered by Optum
• Some employee assistance programs (EAP) that use the Optum network

On your card

Your medical card may say UnitedHealthcare while the behavioral health line on the back says Optum. Either way, use the behavioral health number.

Four questions for the number on your card

1. 1.Call the member services number on the back of your card and ask for behavioral health benefits.
2. 2.Ask: is Brett C. Larsen, LPCC-S, in network for outpatient mental health visits under my plan?
3. 3.Ask what you pay per visit: a copay, or coinsurance after a deductible, and how much of the deductible is left.
4. 4.Ask whether video visits are covered the same as office visits.

Video sessions: Optum covers video visits with in-network providers under most plans. Confirm whether your plan pays telehealth at the office-visit rate.

Plans Brett sees

• Employer plans (Blue Access, Blue Preferred, PPO and HMO products)
• Individual and family Marketplace plans
• Anthem Ohio Medicaid and Kentucky Medicaid managed care; benefits differ, ask on the call

On your card

Look for the Blue Cross and Blue Shield cross and shield with "Anthem." Cards from other Blue plans carry a suitcase logo; those may pay through the BlueCard program, so ask.

Four questions for the number on your card

1. 1.Call the member services number on the back of your card and ask for behavioral health benefits.
2. 2.Ask: is Brett C. Larsen, LPCC-S, in network for outpatient mental health visits under my plan?
3. 3.Ask what you pay per visit: a copay, or coinsurance after a deductible, and how much of the deductible is left.
4. 4.Ask whether video visits are covered the same as office visits.

Video sessions: Anthem plans in Ohio and Kentucky generally cover video counseling with in-network providers. Some plans set a different copay for telehealth, so ask.

Plans Brett sees

• Ohio Medicaid managed care
• Kentucky Medicaid managed care
• CareSource Marketplace individual plans in Ohio and Kentucky

On your card

CareSource cards say which program you are in. Medicaid and Marketplace benefits work differently, so tell Brett which one you have.

Four questions for the number on your card

1. 1.Call CareSource member services on your card and ask for behavioral health benefits.
2. 2.Ask whether Brett C. Larsen, LPCC-S, is in network for outpatient counseling under your plan.
3. 3.Medicaid members usually have no copay for counseling. Marketplace members should ask about copay or coinsurance and deductible.
4. 4.Ask whether video visits are covered the same as office visits.

Video sessions: CareSource covers telehealth counseling for Medicaid and Marketplace members. Video sessions with Brett run on Carepatron, not on the Teladoc line CareSource advertises.

Plans Brett sees

• Employer plans (Aetna Choice POS II, Open Access, HMO)
• Individual plans through Aetna CVS Health
• Medicare Advantage varies; ask on the call

On your card

Aetna cards list the plan type on the front. A POS or PPO plan is the most likely to include out-of-network benefits if in-network does not apply.

Four questions for the number on your card

1. 1.Call the member services number on the back of your card and ask for behavioral health benefits.
2. 2.Ask: is Brett C. Larsen, LPCC-S, in network for outpatient mental health visits under my plan?
3. 3.Ask what you pay per visit: a copay, or coinsurance after a deductible, and how much of the deductible is left.
4. 4.Ask whether video visits are covered the same as office visits.

Video sessions: Aetna generally covers video counseling. Confirm the rate for your plan.