That's right - we take insurance!
Part of our mission is to make sure that there is a place where you can get psychotherapy with your insurance, which makes us very rare indeed. We know that these days, insurance is an intricate maze and we're here to help you navigate it. If you have qualified for Medicaid, please remember that you must also choose a plan to provide the Medicaid benefits to you - the list of plans we accept is below. We don't accept what is known as "Straight Medicaid". However, it is easy to get a plan - you just choose one and call them and let them know that you have Medicaid but need a managed care plan.
If you do not have insurance, we are happy to offer you a sliding scale (see below). However, even if you pay the minimum fee of $80, it still might be cheaper to look into the rates for the Affordable Care Act Plans, or even to see if you qualify for a Medicaid plan, which is free. Once you qualify for Medicaid or the Affordable Care Act, you only need to choose a plan. (see the list of plans we take below). As the current Administration is cutting funding to help people sign up for the ACA and Medicaid, we are doing our best to help educate people on their public insurance options. We're happy to give you guidance about this process if you need it - just click on Contact Us above. For more information, a good place to start is the NY State of Health Website: https://nystateofhealth.ny.gov/. Their help line is 855.355.5777.
Checking your benefits
When you email us your information (Click on Contact Us), we are happy to check your insurance benefits for you. We do our best to get the most accurate information from your insurance about your benefits. However, insurances often quote us incorrect information. For this reason, we ask that you check your own benefits as well. This way, we can ensure that the information we have is correct.
Calling your own Insurance to Find out your Benefits
When you call your insurance, you'll want to use the phone number on the back of your Insurance Plan's card. You should ask about your behavioral/mental health benefits for "Outpatient Mental Health Office Visits" (CPT codes: 90791, 90834, 90846, & 90847).
-In-Network: If your insurance plan is listed below, you should ask about In-Network benefits, meaning that we are part of that insurances "network" of providers.
-Out of Network: If your insurance is not on the list below, (or listed as “out-of-network only” you should be asking about Out-of-Network benefits (more on Out-of-Network below).
Terms you need to know:
**Don't worry if you’re still unclear, we'll help explain the numbers for you once you have them!
-Allowed amount - the amount your insurance deems acceptable for Mental Health Office Visits (this varies by insurance. We charge $250 per session, however, each insurance determines how much of our fee they are willing to pay. That is the “allowed amount” For most in-network insurances, it is a flat fee, and we write off the remainder. For many out-of-network insurances, it is a percentage. This is an important number to know if you have a deductible, because this is the amount you will pay per session. For most in-network plans, we already know the amount.
-Deductible (this is the amount you have to pay before the insurance will start paying anything). If you have one, you should also ask how much of it you have left. Your fee will be tied to the contracted rate or “allowed amount” your insurance sets for our services. This varies greatly between insurance. After you have paid your deductible, sometimes you have a Co-pay or Co-insurance that you have to pay from then on (see below).
-Co-pay (flat fee that you must pay per appointment) or Co-insurance (a percentage of the total fee or “allowed amount” that you must pay per appointment)
-Effective Date (the date your insurance became active)
-Re-certification date (mark this on your calendar so that you know when you need to submit paperwork to re-certify)
-Primary Insurance (just to make sure that you're not mistakenly listed under another insurance, for example, your previous insurance, your parent's insurance, your partner's insurance, etc.)
We accept all types of the plans below, including Medicaid, Medicare, ACA, and private plans. We do not accept “straight” Medicaid or Medicare (that is, Medicaid or Medicare without a Plan). If you have Medicaid/Medicare without a plan, you should call them right away and choose a plan. Here is the list of plans we accept:
Blue Cross Blue Shield (Any State)
Empire Blue Cross Blue Shield of NY
Empire Blue Cross Blue Shield HealthPlus
And some other lesser known plans.
Out of Network plans:
Beacon Health Options
Any other plan with out-of-network benefits.
Please email us the name of your insurance so we can check it for you.
While our full fee is $250 per session, we do offer a sliding scale to those with financial need, ranging from $80 t0 $150, depending on what a patient can afford.
If you have Out-of-Network benefits, your payment is due at the time of service, however, we're happy to file all your claims with your insurance company for you as a courtesy. Sometimes insurances will actually pay us directly, in which case, you're only responsible for whatever deductible, co-pay, or co-insurance is applicable. If you have a deductible, your fee will be based on your insurance’s “allowed amount.”