Amerigroup for Therapy

Amerigroup is a health insurance company that offers coverage in several states across the country. They provide HMO, PPO, Medicaid, and Medicare plans to suit your lifestyle, all of which provide mental health benefits.

Does Amerigroup cover therapy?

Yes, Amerigroup plans provide some coverage for therapy sessions. Using your Amerigroup plan can help you decrease your out-of-pocket costs when it comes to mental health services.

The least expensive option is to work with a therapist who is in-network with Amerigroup. Some Amerigroup plans do not offer out-of-network coverage, which means that you’ll need to pay for the whole session fee.

For this reason, it’s important to know the exact details of your Amerigroup plan so you don’t end up with unexpected costs.

How do I check if my Amerigroup plan covers therapy?

To check if your Amerigroup plan covers therapy services, review your Summary and Benefits document. You likely received this document when you first enrolled in your Amerigroup plan. It shows you exactly what Amerigroup will pay for based on the type of service you want to receive — therapy will be under “outpatient individual and group therapy services.” This document will also differentiate between in-network providers and out-of-network providers.

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. An Amerigroup customer service representative can talk you through the coverage available to you through your specific plan.

How much does therapy cost with my Amerigroup plan?

Depending on the type of plan that you have, you might either receive free therapy services or need to pay a $25 copay. Amerigroup’s Medicaid and Medicare plans generally cover all therapy costs, meaning that you won’t need to pay anything out-of-pocket. Otherwise, every time you meet with your therapist, you will need to pay them the copay amount. For out-of-network therapists, this copay may be much higher.

What types of mental health conditions does Amerigroup cover?

Amerigroup plans offer coverage for many mental health conditions, including all mental health conditions that are eligible for a specific diagnosis. When you start seeing your therapist, they will provide you with a diagnosis, which will be coded on your Amerigroup paperwork and will enable you to continue accessing low-cost therapy.

Some common mental health conditions include:

What types of therapy does Amerigroup cover?

Amerigroup has mental health benefits that cover many different types of therapy. These types of therapy must be provided by a credentialed mental health professional such as a psychologist, social worker, or counselor. Your therapist needs to take an evidence-based approach to working with you, meaning that the type of therapy they offer must have clinical research backing its efficacy.

Here are some commonly used types of therapy:

What types of therapy does Amerigroup NOT cover?

Amerigroup will not cover any therapies that are not evidence-based and not appropriate for your specific diagnosis. Your Amerigroup plan will not cover career counseling, life coaching, aromatherapy, reiki healing, or acupuncture. While many people find these types of therapy helpful for their well-being, these modalities lack the clinical rigor necessary for coverage.

Does Amerigroup cover online therapy?

Yes, Amerigroup covers online therapy. Whether you choose to see your therapist in-person or through an online platform, your Amerigroup benefits remain the same — you’ll pay the same copay no matter the location of your session.

Amerigroup offers its members access to an online resource called LiveHealth Online Psychology, in addition to access to low-cost therapy. This online platform gives members access to psychiatrists and therapists through the Health Management Corporation.

Does Amerigroup cover couples therapy?

Amerigroup does not cover couples counseling. Because Amerigroup requires a mental health diagnosis when providing benefits, couples counseling is typically not eligible coverage.

However, couples counseling can still be affordable through other options.

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

Whether you need to see your primary doctor before starting therapy depends on the type of plan you have. If you have an HMO, you will need a referral from your primary doctor before you’re eligible to use your Amerigroup coverage to pay for therapy services. If you have a PPO, Medicaid, or Medicare plan, however, you won’t need a referral and can find a therapist whenever you’re ready.