Therapy can be a valuable tool in managing mental health conditions and improving overall quality of life. Unfortunately, cost is often a significant barrier preventing people from seeking therapy. This is where health insurance can play a crucial role in providing access to affordable mental and behavioral health services.
The good news is, if you have coverage through Amerihealth Administrators Health Insurance, you will be able to access mental health benefits. Amerihealth acknowledges the importance of mental health and the role therapy plays in improving mental and behavioral health outcomes for many individuals.
What Is Amerihealth Insurance?
Amerihealth Administrators Health Insurance is a leading national Third-Party Administrator (TPA) that offers innovative administrative and Business Process Outsourcing (BPO) solutions to self-funded health plans, carriers, and administrators.
The company provides comprehensive and cost-effective health insurance solutions to a wide range of clients, including large and small businesses, municipalities, school districts, and individuals. They are dedicated to improving health and well-being while ensuring affordability.
Amerihealth Insurance is part of the Amerihealth family of companies, which operates in all 50 states. With a focus on understanding the unique needs of each individual, Amerihealth Administrators aims to provide tailored health insurance options that work for their clients to address their medical conditions and help them thrive.
Amerihealth Insurance is associated with All Savers insurance and is part of the UnitedHealthcare family of insurance companies. This affiliation strengthens their network and provides members with access to a wide range of healthcare providers.
Does Amerihealth Insurance Cover Mental Health Therapy?
What sets Amerihealth Insurance apart from other providers is their commitment to prioritizing mental health coverage. They understand the importance of addressing mental health conditions and strive to offer comprehensive benefits for therapy and other mental health services to address various mental health conditions.
What Types of Mental Health Conditions Does Amerihealth Cover?
Amerihealth Insurance covers a broad range of mental health conditions, including but not limited to:
- Depression
- Anxiety disorders
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Eating disorders
- Substance use disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Schizophrenia
- Autism spectrum disorder (ASD)
- Personality disorders
What Types of Therapy Does Amerihealth Cover?
Amerihealth Insurance covers various types of therapy to cater to individuals’ specific needs. These may include:
- Individual therapy: One-on-one sessions with a licensed therapist/counselor.
- Group therapy: Therapeutic sessions in a supportive group setting.
- Family therapy: Therapy involving the individual and their family members to address relational dynamics and support systems.
- Cognitive behavioral therapy (CBT): A goal-oriented therapy that focuses on changing negative patterns of thinking and behavior.
- Dialectical behavior therapy (DBT): A therapy that combines elements of CBT with mindfulness techniques, primarily used in treating emotional dysregulation and unsafe behaviors.
- Eye movement desensitization and reprocessing (EMDR): A therapy used to treat trauma-related disorders.
- Inpatient addiction treatment through Shatterproof’s Treatment Atlas
- Prescription drug benefits for some conditions
What Types of Therapy Are Not Covered by Amerihealth?
Amerihealth Insurance plans may not cover certain experimental or alternative therapies that are not considered medically necessary or evidence-based. This includes music therapy, equestrian therapy, and hippotherapy. Additionally, coverage for certain specialized or intensive therapies, such as residential treatment programs, may be limited or require prior authorization.
If you’re considering an alternative form of therapy or mental health treatment, you should carefully review your insurance policy documents or contact Amerihealth directly to understand the specific limitations or exclusions related to mental health coverage. In some cases, you may need to demonstrate a need for certain therapies based on pre-certification, your claims, or a referral from your healthcare provider.
What if I Want Online Therapy?
Amerihealth Insurance recognizes the growing importance and convenience of online therapy. Policyholders can access Amerihealth’s Telebehavioral Health services, which allow you to have virtual visits by phone or video chat with a licensed mental health professional in a time and place that is convenient and comfortable for you.
To access these services, you can locate a tele-behavioral health provider by calling the number on the back of your ID card under Mental Health/Substance Abuse. If you’re already working with a therapist, you can also check with them to see if they offer virtual visit options.
You can also book online therapy through Grow Therapy. Visit the Grow Therapy search page and input your insurance info and location to view a list of therapists who match your criteria. You can then book an online appointment directly through the therapist’s profile.
Find an in-network therapist
What if I Want Couples Therapy?
Couples therapy is an important form of therapy that focuses on enhancing relationship dynamics. Amerihealth Insurance may cover couples therapy as part of their mental health benefits. You should review your specific policy details or contact Amerihealth Insurance to ensure coverage for couples therapy before making an appointment with a therapist.
It’s important to note that insurance providers don’t commonly offer coverage for couples therapy due to several reasons. One key reason is that relationship issues, in and of themselves, are not considered a mental health diagnosis. Insurance coverage for therapy typically requires a diagnosable mental health condition, and couples therapy is often classified as a non-covered service because it primarily focuses on interpersonal dynamics rather than individual mental health diagnoses.
Do I Need to Talk to a Doctor First?
In most cases, Amerihealth does not require a doctor’s referral to access mental health services. Still, it is important to check your specific plan ahead of time to confirm whether or not you require a referral for therapy in order to receive coverage.
How Do I Check if My Amerihealth Insurance Plan Covers Therapy?
To determine if your specific Amerihealth Insurance plan covers therapy, you can visit their official website or contact their customer service. They provide detailed information about the coverage and benefits associated with each plan. There, you can verify if therapy services are included and under what conditions.
How Much Will Therapy Cost with Amerihealth?
The cost of therapy with Amerihealth Insurance will depend on several factors, including cost-sharing structure of your specific insurance plan, deductible, co-insurance, and co-pay. Here are some key terms to understand:
- Deductible: The amount you must pay out-of-pocket before your insurance coverage begins.
- Co-insurance: The percentage of the cost you are responsible for after meeting the deductible.
- Co-pay: A fixed amount you may be required to pay for each therapy session.
Amerihealth currently only offers Health Maintenance Organization (HMO) plans to individuals and families. An HMO plan is a type of health insurance plan that is designed to protect you and your family from the costs of medical services when you’re sick or injured. It also covers the cost of preventive care services to promote your health and well-being.
When you enroll in an HMO plan with Amerihealth, you agree to pay a specific monthly premium. In return, you agree to use an in-network primary care physician (PCP) or family doctor to coordinate your care. Your PCP will treat your general health needs and refer you to specialists when necessary. Amerihealth covers a portion of your covered healthcare costs when you use in-network providers. It’s important to note that out-of-network doctors or hospitals are generally not covered, except for urgent care and emergency services.
To pay for therapy with Amerihealth insurance, you would typically follow these steps:
- Check your benefits: Review your Amerihealth plan to understand what mental health services are covered, including therapy. This can usually be done by accessing your Amerihealth member account or contacting Amerihealth directly.
- Find an in-network therapist: Choose a therapist who is in-network with Amerihealth. This means they have a contract with Amerihealth and have agreed to accept their approved fees for services. This can be done through the Grow Therapy website.
- Obtain a referral if needed: In some cases, HMO plans like Amerihealth may require a referral from your PCP before you can see a therapist or specialist. Check with your PCP to see if a referral is necessary for therapy services.
- Pay any applicable copays or deductibles: Depending on your specific Amerihealth plan, you may be responsible for paying copayments or deductibles. These costs can vary depending on your plan and the services received.
You can also use the Grow Therapy cost estimator tool to get an idea of your out-of-pocket costs before making an appointment.
How much will your therapy cost?
It’s important to note that the exact details of paying for therapy with Amerihealth insurance may vary based on your specific plan. It’s always recommended to review your plan documents or set up a consultation with an Amerihealth representative for the most accurate and up-to-date information.
How Do I Find a Therapist Through Amerihealth?
To find a therapist through Amerihealth Insurance, you can follow these steps:
- Visit the Amerihealth Insurance website.
- Look for a provider directory or search tool.
- Enter your location and the specialty of therapy you are seeking.
- Review the list of in-network providers and their contact information.
- Contact the providers to verify their availability and schedule an appointment.
Amerihealth Insurance aims to provide a user-friendly process for finding therapists within their network. Utilizing their online tools or calling their customer service can help simplify the therapist search process.
Improving Mental Health
Taking care of your mental health is a crucial aspect of overall well-being. Amerihealth Insurance recognizes the importance of mental health coverage and strives to provide comprehensive benefits for therapy services. By understanding the coverage options, therapy types, and the workings of your specific Amerihealth Insurance plan, you can access mental health services that are both effective and affordable.
Remember to review your policy details or contact Amerihealth Insurance directly for any specific inquiries regarding therapy coverage. Seeking therapy can be a positive step towards improving your mental health, and with Amerihealth Insurance, it may be more accessible than you think.
If you’re an Amerihealth policyholder, don’t wait to take advantage of the mental health coverage. Together, let’s make your mental health journey a priority.
