Beacon Health Options
Finding a therapist can be challenging, especially when you want to use your insurance benefits to pay for therapy.
We’re setting out to make this process a little easier by filling you in on everything you need to know about using Beacon Health Options to pay for therapy. If you have Beacon Health Options insurance, read on to learn all the details.
Does Beacon Health Options cover therapy?
Yes, Beacon Health Options does cover therapy under most insurance plans.
That said, your coverage for therapy depends on what kind of insurance plan you have through Beacon Health Options. The details of your coverage may vary based on several factors, so be sure to check your plan documents and/or contact the provider directly to find out exactly what your plan covers.
How much does therapy cost with a Beacon Health Options plan?
The exact cost of therapy will change depending mostly on two key factors: A) your specific plan’s benefits, and B) whether or not you’re seeing a therapist who’s in-network with Beacon Health Options.
About your plan’s benefits
To find out how much you’ll pay per therapy session, you’ll need to consider the following two aspects of your insurance plan:
- Deductible: Your deductible is the total amount you need to pay for medical costs each year before your insurance coverage begins. (All your medical costs contribute to this, not just therapy costs.) If you haven’t yet met your deductible for the year, then your insurance usually will not cover therapy sessions, and you will be responsible for the full cost.
- Coinsurance: Your coinsurance is a set fee you pay at every therapy session, after your deductible is met. This typically ranges from $15 to $50 per session.
About in-network therapists
An in-network therapist is one who already has an arrangement to work with your insurance company.
- If your therapist is in-network, then you will have to pay coinsurance or make payments toward your deductible (see the info on this above). The final cost for an in-network therapist depends on your specific plan.
- If your therapist is out-of-network, then you will have to pay the whole fee the therapist charges up front (or the sliding scale rate, if you’ve agreed on this rate with your therapist.) You may be able to get reimbursed for a portion of out-of-network costs by taking advantage of your plan’s out-of-network benefits.
To find out more about your deductible, coinsurance rates, or out-of-network benefits, check your summary of benefits or contact Beacon Health Options directly by calling the number on the back of your insurance card or using the online client portal.
What types of therapy does Beacon Health Options cover?
Depending on your specific insurance plan, Beacon Health Options often covers many different kinds of psychotherapy. Therapy options usually include coverage for both mental health conditions and substance use issues.
Your therapist might use a variety of techniques, but some common types of individual therapy that Beacon Health Options usually covers include cognitive-behavioral therapy (CBT) and psychodynamic therapy.
You might also be covered for family therapy and/or group therapy under your Beacon Health Options plan, depending on the details of your specific coverage.
Before starting therapy, you should always double-check that your therapist accepts your Beacon Health Options insurance plan. You can also contact Beacon Health Options directly to find out more about what kinds of therapy your plan covers, either by calling the number on the back of your insurance card or using the online client portal.
What kinds of therapy does Beacon Health Options not cover?
Like most kinds of insurance, Beacon Health Options does not usually cover the following kinds of treatment:
- Couples counseling (see below for more info and ways to pay for couples counseling)
- Life coaching
- Career coaching
- Therapy sessions occurring outside the therapy office
If you’re not sure whether a certain kind of therapy is covered under your plan, you can always contact the company directly to find out.
What conditions does Beacon Health Options cover?
Compared to some other kinds of insurance, Beacon Health Options tends to have relatively wide coverage for mental health and behavioral health treatment. For example, many Beacon Health Options plans include coverage for the following:
- Alcohol use and/or substance use treatment
- Psychiatric medications
- Inpatient or residential mental health treatment
- Ongoing outpatient therapy
- Emergency and crisis mental health treatment
However, your coverage will vary depending on your specific plan. To know for sure whether the kind of treatment you’re looking for is covered, it’s usually best to check your summary of benefits or to contact Beacon Health Options directly by calling the number on the back of your insurance card or using the online client portal.
Some common mental health conditions that Beacon Health Options often covers include:
It’s also important to know that if you want to use insurance benefits to pay for therapy, your therapist is required to assign you a diagnosis for at least one specific mental health condition. The therapist also has to share that information with your insurance company.
If you don’t want your insurance company (or family members, if you have a shared plan) to have access to this information about your mental health, it may be best to consider out-of-network options instead of using your insurance benefits.
Does Beacon Health Options cover online therapy?
Yes, Beacon Health Options does sometimes offer online therapy through its telehealth program.
To find out whether your plan includes an online therapy option, you can contact the company directly to find out more.
Additionally, Beacon Health Options offers a variety of self-directed online mental health resources. You can find these resources on the Member Health Tools web page.
Does Beacon Health Options cover couples counseling?
No, Beacon Health Options generally does not cover couples counseling.
However, even if you can’t get coverage for couples counseling through Beacon Health Options, you can still explore other ways to afford couples counseling on a budget. Here are five ways to pay for couples counseling if it’s not included in your health insurance plan.
Do I need to see my doctor before visiting a Beacon Health Options therapist?
You may need to get a referral from your primary care physician to see a therapist through Beacon Health Options, depending on what kind of plan you have.
Here are the requirements for the different kinds of Beacon Health Options plans, though your exact coverage might vary:
- HMO: Yes, you are typically required to see your primary care physician for a referral to therapy before your insurance company will provide outpatient coverage.
- POS: Yes, you are typically required to see your primary care physician for a referral to therapy before your insurance company will provide outpatient coverage.
- PPO: No, you typically don’t need to see your primary care physician for a referral before accessing outpatient mental health services.
- EPO: No, you typically don’t need to see your primary care physician for a referral before accessing outpatient mental health services.
If you do not get a referral, you may want to call your member services number directly to check whether you need pre-authorization in order for your insurance to cover therapy.