There are several different types of insurance that cover therapeutic services, however, the length of therapy allowed and the kinds of diagnoses covered under individual insurance plans can vary. We recommend you contact your provider to discuss the current benefits of your policy. Listed below are several insurance options which do cover therapy.
Preferred Provider Organizations (PPO's)
PPO's are insurance plans that contract with networks of providers to supply services. Patients are offered lower cost-sharing to use providers on the "preferred" list but can use non-network providers at a higher out-of-pocket cost. Therapists are typically paid on a discounted fee-for-service basis.
Point-of-Service (POS)
POS plans are managed care plans that combine features of pre-paid (or capitated) and fee-for-service insurance. Patients can choose to use a network provider at the time of service. A significant co-payment typically accompanies use of non-network providers. Although few plans are purely of one type, an important difference between a PPO and a POS is that in a PPO plan, the patient may select any type of covered care from any in-network provider, while in a POS, use of in-network services must be approved by a primary care physician.
Carve-Out Managed Behavioral Health Care
In carve-out managed behavioral health care, segments of insurance risk-defined by service or disease-are isolated by overall insurance risk and covered in a separate contract between the payer (insurer or employer) and the carve-out vendor. Even with highly restrictive admission criteria, many HMO's have recently found it cost-effective to carve out mental health care for administration by a managed behavioral health company.
