Insurance

Insurance

Insurance plans with mental health out-of-network benefits are accepted and Dr. Saler is currently a participating provider on Aetna's Behavioral Health Network.

It is important for individuals to call their insurance companies to find out exactly what mental health services are covered. All plans have certain rules, limits, and procedures. Sometimes a pre-authorization for services is required and often a deductible needs to be met before any reimbursements. In addition, there may be a limit to the number of visits allowed per year and a maximum amount of allowed charges per year and in a lifetime.

The following are some helpful questions that individuals can ask their insurance company:

• Do I have mental health benefits?
• If yes, do I need to see someone on the insurance company provider list only or am I also covered for out-of-network providers?
• If Aetna is my mental health insurance provider, what is my co-pay and/or co-insurance?
• Do I need to meet a deductible before receiving any reimbursements or paying any co-insurance or co-pays?
• If a deductible needs to be met, how much is the deductible and how much of it have I already satisfied this year?
• With out-of-network benefits being used, once the deductible has been met, what does the insurance company consider to be the usual and customary individual psychotherapy (code 90806) fee for a licensed psychologist in my geographical area and what percentage of that fee do they cover?
• How many sessions per calendar year does my plan cover? (Please note: recent experience with insurance companies indicates that number of sessions per calendar year is not a guarantee that the company will ultimately approve this number of sessions.)
• Is there a maximum amount of charges allowed per year or in a lifetime?
• Do I need pre-authorization from the insurance company or a referral or approval from my primary care physician before my first appointment?

In initial sessions, Dr. Saler will discuss options for continuation of treatment if and when session limits are met.

Individuals who do not have health insurance, mental health coverage, and/or out-of-network mental health coverage are encouraged to discuss their situation further with Dr. Saler.