Blue Cross Blue Shield of IL Blue Choice | Mental Health Insurance Coverage — Zencare

Blue Cross Blue Shield of Illinois Blue Choice for Therapy

Blue Cross Blue Shield is a large health insurance company that offers plans across the country. In Illinois, one of their health insurance offerings is their Blue Choice plan. This plan, generally provided to employees through their employers, provides health coverage — including therapy coverage! — through three different plan levels: Bronze, Silver, and Gold.

Does Blue Cross Blue Shield of IL Blue Choice cover therapy?

Yes, Blue Cross Blue Shield of IL Blue Choice provides coverage for mental health services including therapy. Some plans offered through Blue Cross Blue Shield of IL Blue Choice help pay for therapy sessions when its members see either in-network or out-of-network therapists. The amount of coverage for therapy services varies based on your specific plan, as there are multiple plans available through Blue Cross Blue Shield of IL Blue Choice — some with more coverage and others with less.

How do I check if my Blue Cross Blue Shield of IL Blue Choice plan covers therapy?

To check if your Blue Cross Blue Shield of IL Blue Choice plan provides coverage for mental health services, locate your Summary and Benefits document. This document will detail out the exact coverage rates for specific services, such as therapy. Often, you can find this document online through your Blue Cross Blue Shield account or portal. On your Summary and Benefits document, look for “outpatient mental or behavioral health” for information on your benefits.

Example Blue Cross Blue Shield of IL Blue Choice Summary of Benefits, with outpatient mental health section highlighted

Otherwise, try giving the Blue Cross Blue Shield of IL Blue Choice customer service hotline a call to learn more about your mental health coverage. You can find this number on the back of your health insurance card.

How much does therapy cost with my Blue Cross Blue Shield of IL Blue Choice plan?

In general, expect to pay a copayment of around $30 each time you meet with your in-network Blue Cross Blue Shield of IL Blue Choice therapist. For out-of-network therapists, you may be responsible for a coinsurance of between 30-40%.

How much you’ll pay out-of-pocket for therapy services depends on your specific plan. There are three types of plans offered through Blue Cross Blue Shield of IL Blue Choice: Bronze, Silver, and Gold. Within these offerings, there are different levels of coverage (generally based on the premium you pay to attain this insurance). Because of the variety of plans, there is a range of coverage available for mental health benefits. Cost per session will also depend on whether your therapist is in-network with Blue Cross Blue Shield of IL or out-of-network and what they charge as a base rate.

Be sure to check the details on your Summary and Benefits document to confirm how much of the cost of therapy will be your responsibility.

What types of mental health conditions does Blue Cross Blue Shield of IL Blue Choice cover?

Blue Cross Blue Shield of IL Blue Choice offers its members coverage for many mental health conditions, including all mental health conditions under a specific diagnosis. When you start seeing your therapist, they will provide you with a diagnosis under which you’ll receive reimbursement.

Some common mental health conditions covered by Blue Cross Blue Shield of IL Blue Choice include:

What types of therapy does Blue Cross Blue Shield of IL Blue Choice cover?

Blue Cross Blue Shield of IL Blue Choice reimburses for all therapy services provided by a credentialed mental health professional. This could include psychologists, psychiatrists, social workers, licensed professional counselors, nurse practitioners, and more.

Therapists need to provide evidence-based, clinically rigorous treatments that are appropriate for the client’s diagnosis. This includes the following therapeutic modalities:

Often, therapists will blend their approaches to treatment for clients. As long as the therapist meets all requirements, their services are eligible for reimbursement.

What types of therapy does Blue Cross Blue Shield of IL Blue Choice NOT cover?

Blue Cross Blue Shield of IL Blue Choice will not cover any therapies that are not evidence-based or based. Treatment also needs to be based upon a specific mental health diagnosis. For these reasons, Blue Cross Blue Shield of IL Blue Choice will not cover career counseling, life coaching, holistic therapies, or reiki healing. They will also not cover hypnosis, ketamine, or psychedelic services, even if they’re accessed for the betterment of mental health symptoms.

Does Blue Cross Blue Shield of IL Blue Choice cover online therapy?

Yes, Blue Cross Blue Shield of IL Blue Choice covers online therapy. Many people prefer to meet with their therapist online, as calling on a secure video platform is convenient, simple, and accessible. Blue Cross Blue Shield of IL Blue Choice recognizes the powerful effects of therapy services, which is why they offer coverage online therapy. The same copayment and coinsurance rates apply, whether in-person or online.

Does Blue Cross Blue Shield of IL Blue Choice cover couples therapy?

Some Blue Cross Blue Shield health insurance plans offer couples therapy benefits to its members. It depends on your specific plan whether or not this is true for you. Often, health insurance companies do not cover these services because they cannot receive the same required diagnosis information like individual therapy.

However, couples counseling may still benefit you and your partner or partners. There are ways to access this type of therapy, even if your health insurance plan doesn’t cover it. These options can even be affordable!

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

No, you do not need to see your primary care physician before you start therapy. This is because all of the Blue Cross Blue Shield of IL Blue Choice plans are PPO, which do not require a referral for specialist services. Without needing to take the time to meet with your primary care physician to attain a referral, you’re all set to start your search for a great therapist whenever you’re ready!