You do not need to use your insurance to pay for private (off-campus) mental health care, but many people do to cover some of the costs. Keep in mind that you are responsible for paying any fees that are not covered by the insurance company.
It is helpful to determine your insurance benefits before attending your first appointment. To do so, call the customer service number on your card and ask to speak with a representative. You should be prepared to provide them with your name, insurance ID number, date of birth, and home address. If you are covered by someone else’s insurance plan (e.g., your parents), you may need to provide their information. You may also use your insurance website to find out information about your benefits.
Tell the representative that you are interested in understanding your mental health benefits. These are sometimes referred to as “behavioral health” benefits. Please note that not all insurance plans provide mental/behavioral health benefits.
Consider asking the following questions:
- Does my plan cover mental health outpatient visits?
- What is the difference between “in-network” and “out-of-network” providers?
- Must I see someone on the provider list?
- Is there anything I need to do to have my sessions covered by insurance?
- How does my coverage differ if I see a provider who is “out-of-network”?
- For how many sessions can I be seen?
- What is my co-pay (dollar amount you are responsible for at each visit) or co-insurance (percentage of the cost of each visit you are responsible for)?
- Is there a deductible (the amount you need to pay before your insurance starts paying their portion of the cost) that I need to pay? If yes, how much is it? How much has been paid to date and how much do I have left to pay?
- Do I need pre-authorization or a referral before meeting with a provider?
If you will be submitting claims:
- What information will you need from my provider for my claims to be paid?
- Where do I send my claims?
- Approximately how long does it take to receive reimbursement?
How to find a provider covered by your insurance:
- Call your insurance company and request a list of local providers.
- Go to your insurance company’s website to search for local providers:
- You may need to create an account or register using your policy number.
- Look for a section such as “find a doctor,” “physician search,” “provider search,” “providers,” or “provider directory.”
- Choose/enter your particular insurance plan.
- Choose/enter your zip code and driving distance range.
- For provider type or type of physician, choose “behavioral health” or “mental health.”
On some sites, you will need to specify a type of provider. Mental health professionals who provide counseling include psychologists, social workers, professional counselors, and marriage & family therapists. Psychiatrists and psychiatric or mental health nurse practitioners can prescribe psychiatric medication. To get the most choices, be sure to search each of these types of providers separately.
Mason Student Health Insurance