AllWays Health Partners | Mental Health Insurance Coverage — Zencare

AllWays Health Partners for Therapy

Allways Health Partners is a health insurance company located in Massachusetts. They were previously known as Neighborhood Health and continue to be a not-for-profit health insurance provider that supports communities across the state. They offer a wide range of health insurance plans and partner with Aetna and Optum networks for coverage. All of these plans include mental health benefits like therapy services.

Does Allways Health Partners cover therapy?

Yes, Allways Health Partners provides coverage for therapy services. However, the amount of the therapy cost they cover depends on your unique health insurance plan. Because Allways Health Partners offers multiple insurance plans, the rates of coverage vary widely, including therapy rates.

On top of this, Allways Health Partners contracts with Optum, a large behavioral health insurer. Depending on which Optum health benefits your plan uses, your cost for therapy may change.

How do I check if my Allways Health Partners plan covers therapy?

To check if your Allways Health Partners health insurance plan covers therapy services, head over to your Summary and Benefits document. You’ll likely find this document through your online Allways Health Partners account or within the paperwork sent to you once you began as a member. Within this document, you’ll find the different rates of coverage — including copayment or coinsurance amounts — for each type of service available. Look for “outpatient services” under mental or behavioral health to see your coverage for therapy. You may have to look at your Optum Summary and Benefits document for specific details about therapy costs.

Example Allways Health Partners Summary of Benefits, with Outpatient Mental Health section highlighted.

If your Summary and Benefits document does not share this information with you, give the phone number on the back of your insurance card a call. The Allways Health Partners or Optum customer service department will share with you the coverage available to you through your plan and answer any questions that you have regarding your benefits.

How much does therapy cost with Allways Health Partners?

Expect to pay a copayment of between $25 - $60 each time you see your therapist in-network with Allways Health Partners. The cost per session with out-of-network therapists may be around a 20% - 40% coinsurance rate — so you’ll pay that percentage of your therapist’s session fee.

Because Allways Health Partners offers so many health insurance plans, how much a person pays for therapy out of their own pocket varies depending on their plan and whether they see an in-network therapist or an out-of-network therapist.

Most Allways Health Partners provides coverage for both in-network and out-of-network therapists. It’s most cost effective to see a therapist that’s in-network with Allways Health Partners, as these services generally have a lower copayment or coinsurance rate.

To better understand your exact copayments or coinsurance rates, find out the details through your Summary and Benefits document.

What types of mental health conditions does Allways Health Partners cover?

Allways Health Partners provides coverage for a wide range of mental health conditions. To reimburse therapists or clients, Allways Health Partners requires that the client receive a diagnosis from their therapist. This diagnosis guides treatment and insurance coverage.

Examples of eligible mental health conditions include:

There are many more diagnosable — and reimbursable — mental health conditions, all of which Allways Health Partners covers.

What types of therapy does Allways Health Partners cover?

Allways Health Partners covers many different types of therapy performed by credentialed mental health professionals. As long as the therapist provides an evidence-based, clinically rigorous therapy modality that is appropriate for the given diagnosis, Allways Health Partners will provide reimbursement for services.

These evidence-based therapy modalities include:

Often, therapists will blend their approaches and use multiple modalities in their treatment. As long as the therapist meets all requirements, their services are eligible.

What types of therapy does Allways Health Partners NOT cover?

Allways Health Partners does not cover life coaching or career counseling, as these are generally based on goals instead of clinical rigor. They also do not cover holistic treatment modalities like aromatherapy, massage therapy, or non-medically required acupuncture. There is no coverage for energy work such as reiki healing. Hypnosis, ketamine, and psychedelic treatments are also not covered, even if in treatment of a mental health condition.

Allways Health Partners requires therapists to be professionally credentialed and offer evidence-based treatment appropriate for the diagnosis.

Does Allways Health Partners cover online therapy?

Yes, Allways Health Partners offers coverage for online therapy. This opens the doors for many clients who aren’t able to physically attend therapy sessions each week. It also makes therapy a convenient, simple component of a weekly routine without having to commute to the office.

Your coverage for therapy costs will remain the same, whether you visit your therapy in-person or online. This includes the same copayments and coinsurance rates.

Does Allways Health Partners cover couples therapy?

Some of the Allways Health Partners plans offer coverage for couples therapy. It depends on the plan, so be sure to check out your specific plan’s details to learn more about your options. Generally, health insurance plans do not cover couples therapy. This is partially because there cannot be a diagnosis to base the reimbursement upon. However, some Allways Health Partners plans may provide coverage at the same or differing rates as individual therapy.

Many couples still benefit from seeing a therapist together. If your Allways Health Partners health insurance plan does not include a couples counseling benefit, there may be ways to decrease the cost of couples counseling, such as sliding scale.

Do I need to see my primary doctor before starting therapy?

Whether or not you need a referral from your primary care doctor before starting therapy depends on the type of plan that you have with Allways Health Partners. If you have an HMO plan, you will need to attain a referral for specialist services from your primary care physician. However, this is a straightforward and common process that should not hinder your access to mental health services.

If you have a PPO plan, you will not need to see your primary care physician before starting therapy. This means that you can begin your therapy journey with a great therapist as soon as you’re ready!