Out-of-network Outpatient Psychotherapy Coverage, Is it Covered?
I have started psychotherapy with a therapist that does not belong to my insurer network.
Is it OK for my insurance not to cover any amount of the therapy cost because the provider does not belong to their network?
Answer
An insurer doesn't have to pay for any out-of-network treatment if the plan doesn't provide coverage out-of-network. That only time this isn't true is for emergency services.
Some plans credit out-of-network costs to your cost sharing amounts, some have specific out-of-network cost sharing, some plans don't have much at all. It's all based on your plan.
Learn more about covered benefits.
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I went to the in network e.r. But was not informed the doctor was out of network. I settled with the e.r. Physican,but keep getting calls from debt collectors for more money. Since 2016.
It is always best to appeal this right away, but essentially this is an issue called “surprise billing” which is hopefully going to be addressed as part of Biden’s plan. https://obamacarefacts.com/bidencare-facts/