Golden Rule Insurance Company for Therapy

Golden Rule Insurance Company was acquired by UnitedHealthcare, a major healthcare insurance company in the United States, twenty years ago. It continues to offer many Americans healthcare coverage in over 40 states under the UnitedHealthOne brand.

Does Golden Rule Insurance Company cover therapy?

Some Golden Rule insurance plans cover therapy, but not all of them. There are many different plans offered through Golden Rule Insurance Company, and they vary in their offerings depending on state and plan type. For example, each state has HSA 70, HSA 100, Plan 100, Plan 80, Saver 80, and Saver 70 plans — all with different coverage for therapy and mental health services.

How do I check if my Golden Rule Insurance Company plan covers therapy?

Because not all Golden Rule Insurance plans offer coverage for therapy, it’s important to check your Summary of Benefits document to understand your benefits. The Summary of Benefits document lists out all of the coverage offered through your plan by service, so you can check the “If you need mental health, behavioral health, or substance abuse services” section. You’ll notice that there are options for outpatient or inpatient services — therapy will be an outpatient service. You then can see your plan’s coverage based on whether you see an in-network or out-of-network therapist. It will be less expensive to see an in-network therapist, should your plan offer you coverage for therapy in the first place.

Another option for checking if your Golden Rule Insurance plan covers therapy is to give them a call. You can find their customer service phone number on the back of your insurance card. When you connect with a representative, ask them what your out-of-pocket costs would be per therapy session. This can help you decide what’s in your budget.

How much does therapy cost with my Golden Rule Insurance Company plan?

How much you’ll need to pay per therapy session will depend on your specific Golden Rule Insurance plan. As previously stated, many Golden Rule Insurance plans do not cover any mental health costs. If that’s the case for your plan, you will need to pay the full session fee out-of-pocket. If your therapist charges $160 per session, then you’ll be responsible for that amount in full.

Other Golden Rule Insurance plans require you to pay a 20% coinsurance for each session with an in-network therapist. That means that you’re responsible for 20% of the session fee — if your therapist charges $160, then you’ll be responsible for $32 each time you see your therapist. For out-of-network therapists, you may need to pay your deductible before you can access the benefits, which also are a 20% coinsurance.

What types of mental health conditions does Golden Rule Insurance Company cover?

As with many other health insurance companies, Golden Rule Insurance plans cover most mental health conditions that receive a diagnosis from a credentialed mental health professional. Some of the common mental health conditions include:

There are many more reasons to see a therapist, most of which are eligible for insurance coverage through Golden Rule Insurance. If you have questions about how diagnosis or insurance claims work, ask your therapist, who can help you understand the backend of the insurance process.

What types of therapy does Golden Rule Insurance Company cover?

After you’ve received a diagnosis, Golden Rule Insurance plans will cover therapy that’s appropriate for the treatment of that diagnosis, and that has clinical research supporting its efficacy. There are many therapy approaches that meet this criteria, including:

Many therapists offer what’s called “eclectic” or “integrative” therapy, which blends together several modalities. As long as your therapist has the professional credentials required to offer therapy and provides Golden Rule Insurance with a list of modalities they’re using, their services are likely to benefit from your Golden Rule Insurance plan.

What types of therapy does Golden Rule Insurance Company NOT cover?

Golden Rule Insurance plans do not cover any therapies not backed by scientific evidence. This means that therapy modalities must have clinical rigor showing that they benefit clients before they’re reimbursable. In fact, therapists who join the Golden Rule network must provide evidence that they’re credentialed appropriately to provide certain therapy modalities.

While often beneficial, therapies like life coaching, massage therapy, reiki healing, and career counseling aren’t covered by insurance. Many therapists integrate these approaches into their work, however also provide eligible therapy modalities to Golden Rule Insurance to meet requirements.

Does Golden Rule Insurance Company cover online therapy?

Yes, Golden Rule offers its members the opportunity to meet with their therapist online via teletherapy. You’ll pay the same amount as you would if you were to meet with your therapist in-person, but have the convenient option to take your therapy session from your home or another safe location.

Some Golden Rule plans offer members access to HealthiestYou by Teladoc Health. This app gives members access to online appointments with doctors, which can be a useful way to book in your appointments and pay through the app. While not all therapists will be on this app, it’s a good tool to access for other telehealth needs.

Does Golden Rule Insurance Company cover couples therapy?

Typically, health insurance plans do not cover couples therapy. This is because diagnosis for couples is difficult, and insurance coverage requires a diagnosis for reimbursement. There are still options for those who would like to access low-cost couples therapy, like sliding scale options or seeing a couples therapist once a month rather than once per week.

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

Some Golden Rule plans require a referral from your primary doctor before starting therapy. If you have an HMO plan, then you’ll need this referral before you can access your therapy benefits. However, if you have a PPO, then you do not need a referral from your primary doctor and you can start therapy once you’re ready.