FEES
My “insurance-free” fee for each individual session is $135. Payment is made by check or cash at the end of each session. I can also accept debit, credit, or Health Savings Account (HSA) cards. Cancellations must be made at least 24 hours in advance to avoid paying the full fee for the missed session.
INSURANCE
Please note, I do NOT take Medicaid, Medicare, or OHP insurance. If you have one of these plans, I will not be able to take you on as a client.
Also note I no longer take EAP benefits.
Cancellations must be made at least 24 hours in advance to avoid paying the full fee for the missed session (insurance companies do not pay for missed sessions, so the FULL fee would become your responsibility).
IN-NETWORK benefits
Not everything people want to seek counseling for is covered by insurance companies. To utilize insurance to pay for your sessions, you must meet criteria for a diagnosable mental disorder whereby counseling is deemed “medically necessary.” Examples include (but are not limited to) major depression, persistent depressive disorder, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, anorexia, bulimia, binge eating disorder, and adjustment disorder. Be aware that when a mental health diagnosis is used, it becomes part of your medical record.
I am currently an in-network provider for the following insurance plans:
- Aetna
- BlueCross/Blue Shield
- MHN/Health Net
- MODA
- PacificSource
OUT-OF-NETWORK benefits
If you have a different insurance provider than the ones listed above, services may be still be covered in full or in part by your health insurance or employee benefit plan if you have “out-of-network mental health benefits.” Please check your coverage carefully by calling up the member services phone number on the back of your insurance card and asking the following questions:
- “Do I have mental or behavioral health benefits?”
- “What is my deductible and has it been met?”
- “Is Sarah Alexander, LCSW a preferred provider on my plan?”
If so:
- “What is my co-pay for seeing a preferred provider?”
- “How many sessions per calendar year does my plan cover?”
- “Do I have to get pre-authorized approval before I start therapy?”
- “When is my renewal date?”
If not:
- “How much does my plan cover for an out-of-network provider?”
- “What is my co-pay for seeing an out-of-network provider?”
- “How many sessions per calendar year does my plan cover?”
- “Do I have to get pre-authorized approval before I start therapy?”
- “When is my renewal date?”
If your insurance company does provide “out-of-network mental health benefits,” let them know you will be seeing me (in case they require pre-authorization) and then you will pay me your portion of the fee with check, cash, or card at each session and I will bill your insurance company directly for their portion of the fee.
Why Some People Choose Not to Use Their Insurance for Mental Health Counseling
While using health insurance benefits allows you to save money in the short term, this benefit should be weighed against the risk of losing the confidentiality of your sessions. Health insurance companies require a mental health diagnosis in order to cover psychotherapy sessions. When you use your health insurance, your counseling sessions and confidential information (including your mental health diagnosis) become part of your permanent medical records. Insurance companies have the legal right to grant access to your medical records, and they often do. Some of the implications of this are as follows:
- Insurance companies are asking for detailed information to justify reimbursement for treatment that you may prefer to keep private. This information may include your diagnosis, symptoms, personal history, substance use (if any) and summaries of your actual session which will become part of your permanent medical records.
- Your permanent medical records are often accessed by other insurance companies and this can have broad implications. For example, you should realize that if you are ever asked whether you have been treated for a psychiatric problem (such as on a life insurance application), you will have to answer “yes” because your permanent records will contain this information.
- Insurance companies have become much more directive with healthcare providers, sometimes even dictating what questions are to be asked, along with a requirement to document the patient’s responses.
- You must have a diagnosable condition for a mental disorder whereby counseling is deemed “medically necessary” to use insurance (i.e. not everything you want to seek counseling for is necessarily covered). And, again, this diagnosis must be reported to your insurance company and becomes part of your record.
- Optimal care sometimes requires more sessions than allowed by insurance companies. Occasionally only a certain number of sessions are covered, regardless of your actual need.