Figuring out what your insurance covers an be confusing, especially when it comes to mental health services.
Now, here’s the good news: many Amerihealth New Jersey insurance plans cover counseling and therapy. This means you won’t have to spend as much money to get the help you need. Keep reading to learn more about what types of mental health services are covered, how to check your benefits, and where to find an in-network therapist.
What Is Amerihealth New Jersey?
Amerihealth New Jersey is a division of Amerihealth Insurance, a major health insurance company that provides affordable coverage to millions of customers across 15 states, especially in the Northeast region. They provide New Jersey residents with a wide range of benefits, including doctor visits, hospital stays, prescription drug coverage, and preventive care services.
Amerihealth New Jersey has an extensive network of healthcare providers that you can choose from within the state of New Jersey.
Amerihealth Caritas New Jersey
Amerihealth Caritas New Jersey is a managed-care health plan for Medicaid patients. They’re committed to making sure that you have access to high-quality, affordable healthcare. The company offers a wide range of services, including:
- Preventive care, such as checkups, immunizations, and screenings
- Primary care services, such as doctor’s visits and prescriptions
- Specialty care services, such as cardiology, oncology, and orthopedics
- Mental health and substance use services
- Long-term care services
Amerihealth Caritas Performcare New Jersey
Amerihealth Caritas Performcare New Jersey provides mental health and addiction treatment services to people in New Jersey. It is a partnership between Amerihealth Caritas New Jersey and Performcare, a national mental health company.
Amerihealth Caritas Performcare New Jersey offers a wide range of services, such as:
- Therapy (one-on-one or group)
- Medication management
- Helping people coordinate their care
- Crisis intervention
- Support groups
- Prevention services
Amerihealth Caritas Performcare New Jersey also provides services to children and adolescents, such as:
- Early Intervention Services
- School-Based Services
- Family Therapy
- Parent Training
Mental Health Services Covered by Amerihealth New Jersey
Insurance companies have mainly focused on physical health. However, AmeriHealth New Jersey understands the importance of treating mental health conditions and covers therapy and mental health counseling services as part of its health insurance plans. This also includes substance use disorder services.
Amerihealth New Jersey coverage includes:
- Outpatient Services: This includes individual counseling, group therapy services, and medication evaluation and management.
- Inpatient Services: For patients who need to stay in a hospital or other healthcare facility for more than 24 hours.
- Telebehavioral Health: In addition to in-person visits, you can have virtual visits with a licensed mental health mental health professional by phone or video chat from home.
- MyStrength Plus: This self-guided online resource offers personalized programs and support for a wide range of topics, including stress, depression, chronic pain, work-life balance, substance use, and anxiety. Remember that the specific therapies covered may vary depending on your specific plan and coverage details.
Services Amerihealth New Jersey Doesn’t Cover
While Amerihealth New Jersey aims for therapy coverage across the board, some types of counseling probably won’t be covered:
- Experimental procedures, medicines, and equipment.
- Services that aren’t medically necessary.
- Intensive services without prior authorization – things like extended inpatient treatment may require prior approval.
- Services by a provider who isn’t in the Amerihealth New Jersey provider network, except for:
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- Emergency services
- Family planning services
- Tobacco cessation counseling services
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Services not covered can change from time to time. It’s a good idea to check with customer service to get the most up to date list.
How to Check Your Benefits
Before starting therapy, it’s important to check your insurance plan to make sure it’s active and covers the mental health services you need. Pay attention to important details like therapy copays, deductibles, session limits, and whether your coverage applies to in-network or out-of-network providers. This will help you understand what costs to expect.
To check your insurance coverage, you have several options:
- Online: Log into your online member account in the Member Portal to view benefits info like copays and deductibles. Therapy coverage specifics will be there.
- Phone: Call Amerihealth’s New Jersey’s customer service line at 1-888-968-7241. Tell them you want to learn about your health benefits and they can walk you through it.
- Mail: If you’d prefer to receive a physical copy of your coverage information, you can request it by mail. Contact Amerihealth New Jersey customer service and inquire about obtaining a printed copy of your coverage details.
Remember, if you have any questions or don’t understand something, reach out to customer service and they will be happy to help you.
Tips for Making the Most of Your Benefits
Figuring out how to get the most out of your insurance can sometimes be confusing, especially when you’re just starting.
Here are some tips to help you get the most out of your coverage:
- Know what your insurance covers. This means finding out what types of therapy your plan covers and how much money your insurance company will pay for each session. You can find this information on your plan’s website or by calling your insurance company.
- Find a therapist who is in your insurance network. This means that the therapist has agreed to work with your insurance company and charge you less for each session. You can find a therapist in your network by using the Grow Therapy marketplace.
- Get approval from your insurance company. Some Amerihealth New Jersey plans require you to get approval from your insurance company before you start therapy. You can do this by submitting a request form to your insurance company.
- Ask your therapist if they offer sliding-scale fees. Sliding-scale fees mean that the therapist charges their clients based on their income. This can be a good option if you are on a tight budget.
- Consider using a telehealth platform. Telehealth allow you to see a therapist online or over the phone. This can be a convenient and affordable option, especially if you live in a rural area or if you have difficulty traveling to a therapist’s office.
By following these tips, you can make the most of your Amerihealth New Jersey therapy coverage and get the support you need to improve your mental health.
What Will Therapy with Amerihealth New Jersey Cost?
The actual cost of therapy will vary depending on your specific plan benefits and other factors such as your deductible, copay, and coinsurance.
If you have Medicaid, Medicare, or Affordable Care Act coverage (ACA), you may have additional options for affordable mental health services. For example, Medicaid covers most mental health services, and Medicare covers mental health services provided by psychiatrists and other qualified mental health professionals.
Here’s a breakdown of some of the common terms you may see on your insurance plan that may determine how much your therapy will cost:
Plan Type
This tells you what type of insurance plan you have. Each type of plan has its own rules about what providers you can see and how much you have to pay for services.
In-Network vs. Out-of-Network
In-network therapists have agreements with Amerihealth New Jersey, which means they charge less. Out-of-network therapists don’t have these agreements, so they may charge more. Choosing an in-network therapist can save you money. Some plans don’t cover out-of-network services, so be sure to check before you pick a therapist.
Find an in-network therapist
Deductibles
Your deductible is the amount of money you have to pay out of pocket before Amerihealth New Jersey starts covering your therapy costs. For example, if your deductible is $500, you may have to pay that amount before Amerihealth New Jersey will cover any of your therapy sessions.
Co-Pays
Your copay is the fixed amount of money you have to pay for each therapy session. Co-pays can vary depending on your plan and the type of provider you see.
Coinsurance
This is the percentage of your medical expenses that you have to pay after meeting your deductible. For example, if your coinsurance is 20%, you have to pay 20% of your medical expenses after meeting your deductible.
Out-of-Pocket Maximum
This is the maximum amount of money you have to pay for medical expenses in a given year. After you reach your out-of-pocket maximum, your insurance will pay 100% of your covered medical expenses.
Find out how much therapy costs with AmeriHealth New Jersey
Finding an In-Network AmeriHealth New Jersey Therapist
The key to affording therapy is finding a counselor who takes your insurance. Here are some tips:
- Use AmeriHealth’s provider directory online and filter for therapists near you, or all customer service and ask for in-network recommendations.
- Visit the Grow Therapy marketplace to get a list of therapists who take your insurance, are in your location, and meet your other specific requirements.
Book a Session Today
Understanding how your Amerihealth New Jersey therapy coverage works can help you make savvy decisions when it comes to getting treatment. There are plenty of affordable options out there that suit both your needs and budget. With Amerihealth New Jersey, you get access to excellent care at lower costs, which means you can get therapy without having to constantly worry about money.
Check out the details of your plan so you can take that first big step towards getting the help you need today.
