Insurance FAQ

Most insurance plans have mental health benefits. 515 Therapy & Consulting accepts Blue Cross Blue Shield, Health Partners, Midland'sChoice/Cigna, Aplos, United Healthcare (including Medica, UMR, Surest, Oscar - limited providers). You may also self-pay, rather than use insurance. For rates or more information, please contact any of our providers or our admin by phone at (515) 402-4395 or text at (515) 203-3236. When using insurance, often a client will owe a co-pay or deductible for each session, similar to a visit to your physician. It is also important to ask your insurance if you owe a deductible or co-pay and what the cost will be to you. Additionally, it is important to know if the particular clinician you would like to see is listed as "in-network." If the provider is not in-network, keep reading for more information about out-of-network benefits. You may also contact your Human Resources department if you are employed to see if your employer offers EAP (EmployeeAssistance Program) benefits, which are no cost visits through an EAP program. We may be in-network with your company EAP, depending on the company.

If you have insurance outside what is listed above, we would be considered an out-of-network provider. This means you pay for sessions directly, and we provide you with a simple document called a superbill that you can submit to your insurance company. Depending on your plan, you maybe eligible for partial reimbursement as most health insurance companies provide both IN-network and OUT-of-network benefits. (In-network providers are those providers who have an agreed upon contract with the insurance company.) Out-of-network providers do not have a partnership with the insurance company. If you would like to see one of our providers who is out-of-network for your insurance, you need to call the phone number on the back of your insurance card to find out if you have out-of-network benefits and inquire as to what those benefits are, so you know what your portion of the cost will be. Unfortunatey, Medicaid and Medicare do not allow superbilling, and do not offer out-of-network benefits like most commercial insurance plans do. In that case, it would be private pay, only.

Again, the best way to find out is to call the customer service number on the back of your insurance card and ask these questions:

1. Does my plan include out-of-network benefits for outpatient mental health?
2. What percentage of the session fee is reimbursed?
3. Do I need to meet a deductible first, and how much remains on it?
4. How do I submit a superbill for reimbursement?

Many of our clients are pleasantly surprised by how much their insurance reimburses once they ask these questions.

A superbill is simply a detailed receipt for your session that includes the information your insurance company needs to process a claim. You would use a superbill if we are out-of-network for your insurance and your insurance offers out-of-network benefits. You would need to call the number on the back of your insurance card to find out if you are entitled to out-of-network benefits. If so, once your insurance processes the superbill, you will be provided partial reimbursement. We provide the superbill to you automatically, just ask—there’s nothing extra you have to do except submit it to your insurance. Most insurance websites tell you how and where to submit the superbill, or you can call your insurance company for details.

If your plan does not cover out-of-network counseling, you are still welcome to work with us as a self-pay client. Some clients also choose to use HSA or FSA funds to cover therapy sessions. Contact our administrative support for pricing information by phone at (515) 402-4395 or text at (515) 203-3236.