Using Insurance for Therapy

OPTUM UNITED OUT-OF-NETWORK

We help clients use their out-of-network insurance benefits to cover the cost of therapy. Here’s how your out-of-network insurance benefits can be applied.

If you have Optum United insurance, you most likely have out-of-network benefits. You also mostly likely do not need pre-approval for a 45 or 60 minute psychotherapy session, and there is no limit to the amount of sessions you can have in a year.

Optum insurance will typically cover 70% of their customary rate or allowed amount for out-of-network coinsurance reimbursements. While some plans set the allowed amount at an artificially low rate ($83 for a 45 minute meeting), other plans use the usual and customary rate ($275 for a 45 minute meeting, and $310 for a 60 minute meeting). To find out what the allowed amount for your specific plan is, please speak to your insurance company.

70% of the usual and customary fee (set at $139, for example) means that insurance will pay $97 of the fee. After reimbursement, you would owe the difference between $97 and your therapist’s rate. 

We have also seen out-of-network deductibles range from $500 – $1,000 depending on the plan.

To receive an approximate estimate of what you can expect to pay for therapy, enter your information into our Insurance Benefits Calculator. You can email us this information and we will cross-verify your benefits on your behalf. 

If you have Optum United insurance, you most likely have out-of-network benefits. You also mostly likely do not need pre-approval for a 45 or 60 minute psychotherapy session, and there is no limit to the amount of sessions you can have in a year.

Optum insurance will typically cover 70% of their customary rate or allowed amount for out-of-network coinsurance reimbursements. While some plans set the allowed amount at an artificially low rate ($83 for a 45 minute meeting), other plans use the usual and customary rate ($275 for a 45 minute meeting, and $310 for a 60 minute meeting). To find out what the allowed amount for your specific plan is, please speak to your insurance company.

70% of the usual and customary fee (set at $139, for example) means that insurance will pay $97 of the fee. After reimbursement, you would owe the difference between $97 and your therapist’s rate. 

We have also seen out-of-network deductibles range from $500 – $1,000 depending on the plan.

To receive an approximate estimate of what you can expect to pay for therapy, enter your information into our Insurance Benefits Calculator. You can email us this information and we will cross-verify your benefits on your behalf.

 

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Amy Schell, LMHC
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Ariel Zeigler, Ph.D
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Caryn Moore, LCSW
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Christina Mancuso, LCSW
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Courtney Cohen, LMHC
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Daniel Rich, LMHC
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Dimitri Mellos, Ph.D
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Elena Beharry, Psy.D
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Eliza Chamblin, LCSW
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Fanny Ng, Ph.D
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Gary Brucato, Ph.D
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Gavin Shafron, Ph.D
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Jen Oddo, LMSW
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Joanna Kaminski, LMFT
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Josh Watson, LMSW
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Justin L.F. Yong, LMHC
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Kristin Anderson, LCSW
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Logan Jones, Psy.D
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Lucas Saiter, LMHC
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Melanie Palmietto, LMHC
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Monica Amorosi, LMHC
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Peter Gradilone, LMSW
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Salima Ndoye, LMFT
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