Regence Blue Shield for Therapy

Regence Blue Cross is a non-profit health insurance company that covers individuals, families, and employers across the Northwest states. Their mission is to provide affordable access to healthcare to promote community health with an emphasis on sustainability.

Does Regence Blue Cross cover therapy?

Yes, Regence Blue Cross offers coverage for its members when they engage mental health services, including therapy. This coverage means that you’ll pay less out-of-pocket using your Regence Blue Cross plan and its mental health benefits.

Regence Blue Cross offers dozens of different types of plans, including those for individuals, families, and employees. The amount of coverage for services, including therapy services, depends on what plan you have. Because of this, it’s important to understand the specific details of your plan so you can avoid any surprise costs when starting therapy.

How do I check if my Regence Blue Cross plan covers therapy?

To check if your Regence Blue Cross plan covers therapy services, locate your plan’s Summary of Benefits document. Documents of this type give you the details about your coverage, broken into in-network and out-of-network providers.

You can find this document through your online Regence Blue Cross online account. If you receive Regence Blue Cross through your employer, likely your HR team has a copy of this document for you to review.

Within the Summary of Benefits of Coverage document, locate the line that’s called “If you need mental health, behavioral health, or substance abuse services.” Therapy costs will be listed under “Outpatient services.” If you need to speak with someone at Regence Blue Cross to better understand your Summary of Benefits document, you can call the number on the back of your insurance card.

How much does therapy cost with my Regence Blue Cross plan?

The exact costs of therapy will vary based on your specific Regence Blue Cross plan. Some plans offer more mental health benefits than others, including coverage for out-of-network providers. All plans have  different copays and coinsurances, so check what your plan offers as you’re exploring therapy options.

Therapy for some Regence Blue Cross plans is completely covered, meaning it won’t cost you anything out-of-pocket to meet regularly with your therapist. Other plans have a copay of between $20-50 per session, or a coinsurance rate of around 20%. Some Regence Blue Cross plans do not provide coverage when you work with out-of-network therapists, meaning you would need to pay the full session fee each time.

What types of mental health conditions does Regence Blue Cross cover?

Regence Blue Cross covers therapy services for many different mental health conditions, all of which will need a diagnosis from a credentialed therapist. A diagnosis makes you eligible for mental health benefits through your Regence Blue Cross plan, and it’s required to start your billing or reimbursement process.

Some common mental health diagnoses include:

There are many more mental health diagnoses, all of which are covered by Regence Blue Cross plans. If you are uncomfortable receiving a diagnosis, you may ask your therapist to keep it between themselves and Regence Blue Cross. You might also consider paying privately to avoid the need to report a mental health diagnosis.

What types of therapy does Regence Blue Cross cover?

Regence Blue Cross covers many different types of therapy, though your therapist needs to be a credentialed and licensed mental health professional such as a psychologist, psychiatrist, social worker, licensed professional counselor, or nurse practitioner. Your therapist must practice an evidence-based therapy modality that has been clinically proven to support people with your diagnosis.

Some examples of evidence-based therapy approaches with proven efficacy include:

Your therapist may blend therapy approaches to offer you more individualized care, which is often called “eclectic” or “integrative” therapy.

What types of therapy does Regence Blue Cross NOT cover?

Approaches that are not clinically rigorous and are not evidence-based do not qualify for coverage by Regence Blue Cross when they’re the sole modality used. For example, when career counseling and life coaching are the only modality used in a session, Regence Blue Cross will not provide coverage. When combined with an evidence-based therapy modality, however, Regence Blue Cross will provide coverage. Other examples of modalities that are not evidenced-based include reiki healing, massage therapy, and acupuncture.

Does Regence Blue Cross cover online therapy?

Yes, Regence Blue Cross provides its members the option to meet with their therapist online rather than in-person. For individuals who want to access therapy in this way, they’ll pay the same amount they would normally pay when seeing a therapist in-person, including the same copay or coinsurance rates.

Regence Blue Cross acknowledges there are many great reasons to meet with a provider online instead of going into the doctor’s office or hospital. Many Regence Blue Cross members find that it helps them fit sessions more easily into their calendars, especially as they don’t need to commute.

Does Regence Blue Cross cover couples therapy?

No, Regence Blue Cross does not cover couples therapy. Couples therapy is generally not covered by insurance plans, so Regence Blue Cross is no exception. Because they rely on mental health diagnoses for benefit eligibility, couples therapy does not receive benefits or coverage.

If you’re still interested in working with a couples therapist, there are other options to explore so you can improve your relationship or work through specific challenges.

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

Regence Blue Cross plans are EPOs, which mean that you do not need a referral from your primary care doctor before starting therapy. Because therapists are considered specialists, your therapy sessions are specialist appointments. Under an EPO, referrals aren’t required before accessing benefits, so you can start therapy whenever you’re ready.