A Practical Guide to Using Employer Health Insurance for Therapy

Employer health insurance is something that can be incredibly beneficial for many employees. However, not everyone knows how to use it properly or how it can be used for various health benefits.

Therapy is something that everyone could benefit from to some degree but getting access to it, isn’t always easy. A lot have to pay for it but there are those who may have the right health insurance with their current employer, which allows them access to free therapy or at least discounted therapy.

Understand your coverage details

It’s important to start by gathering information about your plan’s specifics, especially when it comes to mental health services.

Reviewing the plan documents is the first step in understanding what your plan includes, in terms of its benefits and coverage. You could also connect with your HR representative in order to get the full outline of benefits and coverage included.

At this point, you should also be contacting your insurer directly.Calling the customer service number on the back of your insurance ID card can help you get in touch with the right department necessary.

Specific questions are worth asking to help ensure everything is covered and that you can move forward without any problems. Here are some questions to ask:

• What are my copayments or coinsurance amounts for in-network and out-of-network therapy sessions?
• Is there a limit on the number of therapy sessions covered per year?
• Are both in-person and online therapy sessions covered?
• Do I need a referral from a primary care physician or a prior authorization for therapy?

It’s also worth asking your yor employee if they offer something called an Employee Assistance Program. This provides a limited amount of free, confidential short-term counseling sessions separate from your main health insurance plan.

Find a provider and schedule in an appointment

Finding a therapist who accepts your insurance (in-network) often results in lower costs. There’s an insurer’s directory that you can use one with your insurer specifically, to search for all available in-network mental health professionals.

It’s important to verify the credentials as directories aren’t always up-to-date. It’s therefore worthwhile to call the therapist’s office directly to confirm that they’ll accept your specific plan and are also accepting new patients.

It’s worthwhile considering out of network options too. If the preferred therapist is OON, then you’ll want to see if your plan offers partial reimbursement.

OON benefits will often have higher costs of out of your own pocket and you may have to pay the full fee upfront, submitting claims for yourself too.

Manage billing and costs

It’s important to manage your billing and costs appropriately to ensure you’re not being overcharged, or in scenarios where you may need to show proof of your claims.

Pay your share

Always be prepared to pay your copay or the full session cost until the deductible is met. This is something that you should always be ready for when it comes to payment.

Keep records

Maintaining your records is certainly important. For example, make sure you’re maintaining records of all communications with your insurance company. This should also include the names of the representatives you speak with, dates of correspondence and summaries of the conversation too.

Use tax-advantaged accounts

If you’ve got a health savings account or flexible spending account, you can use these pre-tax dollars in order to pay for eligible mental health expenses. These all include deductibles and copays, which reduce your overall costs.

Review explanation of benefits

After a claim is processed, your insurer will then send an EOB which details what was billed, what coverage was offered and what you owe specifically. It’s important to review these carefully for errors.

Appeal denials

If a claim is denied unfairly, then you do have a right to appeal the decision. You can also contact the U.S Department of Labor for assistance if needed.

The benefits of therapy as an employee

There are some incredible benefits of taking advantage of therapy, especially an employee. Individual benefits and team benefits can all stem from embracing therapy in your day to day life. With that being said, here are some benefits of therapy that are worth knowing about to hopefully encourage more people to take it up if they feel it’s necessary.

Stress and burnout management

Therapy can be great for learning strategies in regards to handling workplace pressure, anxiety and emotional fatigue. This is a great way of helping prevent burnout from occurring too.

Enhanced productivity and focus

With the use of Aetna Therapists, you can develop tools to navigate all the personal challenges that come with conflicts in life. Being able to improve your coping skills is important so that you can continue on with your day-to-day life both in the workplace and outside of it. Personal challenges like grief and divorce can all be helped with the inclusion of therapy.

Greater resilience

It’s good to build emotional strength in order to bounce back from any setbacks and to adapt to change where it’s required.

Having that greater resilience in life can be useful in a number of ways, especially if you struggle to bounceback from those ‘failures’ in life.

Better work-life balance

Who doesn’t want a better work-life balance? It’s something that most people strive to achieve and not everyone masters it. Gaining perspective can be done with therapy and that helps to seperate personal and professional life. It can reduce overall stress within your life in general.

Boost confidence and morale

Developing a self-awareness is helpful when it comes to boosting your confidence and morale. These strategies are helpful for assertive and respectful communication, which further helps to boost self-esteem.

For teams, there are many benefits for individuals to seek out therapy. A supportive culture is created when mental health is prioritized. It also helps in fostering openness and trust.

Employers will find that there’s a reduced absenteeism and presenteesim, with higher retention rates with employees in general. Building strong relationships is also helped by individuals having therapy.

There are plenty of great benefits to therapy and if your employer health insurance provides it, it’s definitely something that should be embraced.