What to ask your insurance provider

6 Important Questions to Ask your Insurance Company before Attending Counselling

In Canada, if you have extended health benefits at work you may be eligible for some coverage of counselling sessions.

Before you come for counseling, call your insurance provider (e.g.,Sun Life, Blue Cross) and ask the following questions to ensure eligibility:

1. Do you cover a Registered Clinical Counsellor?

Most insurances cover counsellors from a variety of professions (social work, psychology, art therapy, expressive therapies); however, some only cover registered social workers and some cover only psychologists while others will cover Registered Clinical Counsellors. Mercedes is a registered clinical counsellor. Check your plan to confirm that they cover this profession.

Would you make an exception? If your company does not cover registered clinical counsellors, you may consider writing to ask the company if they would make an exception. Because the fee for a registered clinical counsellor is usually less than a psychologist, your provider may make an exception in your case.

 2. How much am I covered for?

Ask the amount of money which you are covered for.

 3. What is the maximum amount paid per session for the therapist?

Insurance companies often pay counsellors below the counsellor’s private practice rate for therapy services. It is important that you know what the insurance company maximum is and what the counsellor’s private practice fee is.

 4. Are there any deductibles?

Ask for information about any deductibles that your insurance company might charge you if you utilize the money allotted for counselling coverage.

 5. Is the coverage for a calendar year or a fiscal year?

Some insurance companies give a set amount of money that you can use in a year for counselling. It is important to know if they base this on a calendar year (beginning in January-December) or a fiscal year (beginning in April to May). Depending on when you need to begin your counselling, this question can make a big difference in the amount of coverage available to you.

 6. Does my counsellor bill the insurance company directly or do I pay up front and then get reimbursed?

This is a very important question to ask. If the counsellor is able to bill the insurance company directly, ensure that you obtain all of the billing information before sessions begin, that is, the name, address and phone number of the company which the counsellor will send invoices to.