Investment

Out-of-Network (OON) benefits provide coverage for healthcare services obtained from providers who are not part of an insurance plan's network. With OON benefits, individuals typically receive a percentage of the allowed amount for these services, which can vary depending on the insurance plan. Prior to receiving OON services, individuals may need to meet a deductible and pay a portion of the allowed amount through coinsurance.

Reimbursement rates are based on the maximum allowable amount set by the insurance plan, and any charges above this limit may be the individual's responsibility. To utilize OON benefits, individuals must submit claims to the insurance company and may need to obtain prior authorization for certain services. It's crucial to review the specific terms and conditions of your insurance plan to understand how OON benefits work for your coverage.

1. What is the coverage percentage for out-of-network psychotherapy services?

2. Do I have a deductible? If so, how much is it and what percentage will be covered once I’ve met it?

3. What is the process for submitting claims for reimbursement?

4. Are there any limitations on the number of sessions or frequency of OON psychotherapy covered?

5. Are there any restrictions on the types of licensed mental health professionals eligible for OON benefits?