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 insurance can be a confusing labyrinth and we're here to help you through it.  We take many commercial plans as well as Medicaid Managed Care Plans.

 If you have qualified for Medicaid, please remember that you must choose a Medicaid Managed Care Plan plan to provide the benefits to you - the list of plans we accept is below.  We cannot bill Medicaid directly - we can only bill certain Medicaid Managed Care plans.

However, it is easy to find out if you have a plan - and sign up for one if you don’t. You can call Medicaid CHOICE Hotline at (800) 505-5678 or try the HRA Medicaid Helpline at (888) 692-6116.   

Medicaid Managed Care Plans are private companies that are contracted to provide insurance to folks who have qualified for Medicaid. Think of Medicaid like the Department of Education and the Managed Care Plans are Charter Schools. Everyone on Medicaid is required to choose a plan.

These plans typically don’t have co-pays, deductibles, or out-of-network benefits.

Affordable Care Act is the program started under Barack Obama, that allows folks to sign up for healthcare with some kind of discount depending on their income.

This includes:
- “Essential Plans” that are essentially the same as Medicaid plans, but usually have small co-pays and a smaller monthly fee.

-”Metal Plans” or “ACA plans” - which are for those who don’t qualify for Medicaid or Essential plans. These are typically more expensive, and are tiered (“Bronze, Silver, Gold, Platinum”). These plans almost always have a deductible, co-pays, and/or co-insurances, with the least expensive Bronze plans having the highest deductibles and the most expensive Platinum plans having the smallest deductibles.

These are private insurance plans that you typically pay for. Often folks have these through their jobs or their parents.

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.    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.

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.

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).  

This is the amount your insurance considers “fair and reasonable” for therapy. This amount varies by insurance. Our full charge is $250 per session which is the “fair and customary” or “allowed amount” set by Medicare nationally for a 53-60 minute therapy session. However, each insurance determines how much of our fee they are willing to pay. This is an important number to know if you have a deductible, because it is the amount you will pay per session, until your deductible is met.

For in-network insurances, they “allow” a flat fee, which we agree to when we become part of their network. We write off the remainder of our full fee. For most in-network plans, we already know the amount.

For out-of-network insurances, it typically $250 and they will pay a percentage of this amount which varies based on your plan. They consider you responsible for the remaining percent. For many out of network plans, we may have to wait until the first claim processes before we know for sure how much they will consider “allowed'“. Until then, we will charge you an estimate.

A Deductible is the total amount you have to pay for all your health services before your insurance will start paying anything.

You will typically have two separate deductibles: one for in-network services and one for out-of-network services.

Once you determine whether we’re in- or out-of-network, you should ask. your insurance how much of your deductible is left for you to pay.

Every time you visit a health provider, your insurance will subtract the “allowed amount” for that service from your deductible until it has reached $0 (as long as you or the provider submits a claim for that health service to them - we submit claims!). We are responsible for charging you that allowed amount.

Once your deductible has reached $0, usually, your insurance will then expect you to pay a “Co-pay” or “Co-insurance” to the health provider (see below).

A set portion - flat fee - of the payment for each appointment (or “allowed amount”) that your insurance expects you to pay.

A portion - calculated as a percentage - of the payment for each appointment (or “allowed amount”) that your insurance expects you to pay.

The date your insurance begins covering health services. Your insurance will not pay for any services occurring before that date.

The due date by which you need to submit your application to continue insurance coverage. A good date to mark on your calendar!

Your primary insurance is the insurance plan that must process any health claims first, before any other insurance (“secondary”) will cover anything.

It is important to make sure you know about all the insurances you might be active under, and which one is primary and/or secondary.

If you get a new insurance plan, you must notify your old insurance and have it turned off - including Medicaid plans - otherwise, it can lead to your new insurance rejecting claims.

For example. if you submit to Insurance A, it turns out you are have another insurance B, (e.g. through Medicaid, your parent, partner, or job) insurance A may refuse to pay for services until Insurance B has processed your claim and paid or denied their part.