What Fees Are Covered by Insurance?
Consumer Info
PsychologyInfo
A Psychologist Is
Starting Therapy
Compare Doctors
Directory
Treatment List
Problem List
Bookstore
Treatment Costs
FAQs
Articles
Forensic Issues
Subject Index
Information Links
Consumer Help

What percentage of the fee is covered by insurance? 

In a point of service plan, you usually have a deductible. After the deductible is satisfied, the insurance will pay a percentage of the fee, and you will be responsible for the balance. The typical point of service plan pays either 80%, 70% or 50% of the fee, and you are responsible for the balance. Some plans have a maximum allowable fee for coverage, but most will pay the covered percentage as long as it is less than the usual customary fee for that service in your geographic area. Some plans pay 100% of the fee after a maximum out-of-pocket expense has been reached. Some plans have a maximum annual benefit. Due to new Federal regulations, your insurance is not supposed to limit coverage for psychological treatment, if it does not limit coverage for other health care. This is called parity coverage.

In a managed care plan, there is sometimes a deductible, but often there is no deductible. You must use a network provider to receive any coverage, unless you have out-of-network coverage, which works like point of service coverage. Only treatment that is approved will be covered, and you will be responsible for all non-authorized treatment costs. You are also responsible for a co-pay. Sometimes this is a flat amount, and sometimes it is a percentage of the total fee. However, if it is a percentage, that amount is based on the negotiated managed care fee, not the  provider's usual customary fee.

Psychology Information Online provides information for Consumers, Psychologists, and Students.
The
National Directory of Psychologists will help you locate a local psychologist.
Our
Self-Help Psychology Bookstore will help you locate books about psychological topics
Students and Professionals like our
Continuing Education and Graduate Training Programs,
Mental Health Professionals use our
Resource Listings (Books and Supplies) and Job Listings.
If you have any comments about the website, please contact us at: 
feedback@psychologyinfo.com
copyright 1999, 2000, 2001 - all rights reserved