Using insurance on Headway

Updated

Insurance plans we accept

With Headway, you can use your insurance plan to pay for mental health care. Providers on Headway currently accept Aetna, Blue Cross and Blue Shield (in select states), Cigna, Oscar, Oxford, United Healthcare, and all Optum affiliates.
 
Our providers are also able to accept a few other third-party insurance carriers whose mental health benefits are administered through the larger insurance networks mentioned above.
 

If you're still unsure of whether your plan is in-network, add your insurance information into your account and our benefit verification tool will be able to check on your information.

If your plan is showing up as unverified, request a manual verification and we'd be happy to let you know whether your specific plan is considered in-network with us or not.

We accept a limited number of Medicare plans, but we do not yet support Medicaid

At this time, we accept select insurance plans affiliated with Medicare; we do not yet support Medicaid.

For a full list of Medicare plans supported today, you can search "Medicare" in the insurance carrier dropdown box on Headway

In the event you’re looking for an in-network provider with a Medicare or Medicaid plan that we do not yet support, we suggest consulting your provider directory with your insurance company or finding a therapist using a third-party resource such as Psychology Today.

Out-of-network insurance plans

Providers are grouped into networks based on agreements with insurance companies. If a provider is considered "out-of-network," it means they don't have an agreement with your insurance company. 

Headway does not work with out-of-network benefits.

In order to access Headway's services and have your insurance cover the costs, you'll need to have an insurance plan that our Headway providers are able to accept. Our providers can accept a variety of insurance plans thanks to the agreements we have with these insurers, and we’re constantly working to partner with more.

If you're still unsure of whether your plan is in-network, add your insurance information into your account and our benefit verification tool will be able to check on your information.

If your plan is showing up as unverified, request a manual verification and we'd be happy to let you know whether your specific plan is considered in-network with us or not. 

 

Understanding your insurance plan

Each individual insurance plan has its own unique set of benefits, or services that are covered under the plan. Your insurance plan sets which services will be covered, and how much of it will be covered by the insurance company.

Benefits vary from plan to plan, but will typically consist of one or more of the following:

Click below to expand and learn more about each term.

Copay

A copay is a flat rate per session set by your insurance plan. With a copay, you’ll pay the same amount for each session regardless of type or length.

Coinsurance
The coinsurance is the percentage of the cost you're responsible for paying after your deductible’s been met. Your insurance covers the remaining percentage.
Deductible
A deductible is a set amount of out-of-pocket spending. With a deductible plan, the out-of-pocket price per session is set by your insurance company. Once you’ve reached your deductible amount, your insurance company will start to contribute to your therapy costs. The percentage per fee they cover is determined by your plan.
Individual deductible

The amount that you as an individual are responsible for paying until your insurance takes on some of the costs.

Family deductible

If you're on a group plan with family members, everyone’s payments will contribute to the deductible total. Once met, the insurance will take on a percentage of the costs for everyone on the plan.

Out of pocket maximum

Some plans consider an out-of-pocket maximum, i.e. the maximum amount you can spend in a given plan cycle. If you meet your out-of-pocket maximum, you won’t have any expenses until your plan resets.

 

 

Deductibles

A deductible is a set amount of money one must pay before insurance begins to pay for care. Plans can have an individual deductible (must be met by the individual seeking care) or a family deductible (if applicable). Deductibles typically reset on a yearly basis.

If your deductible is:

Not met

  • Sessions are billed at the full session rate (set by insurance), and will vary depending on the CPT code(s) used
  • While paying the full rate with insurance may seem non beneficial, using insurance allows:
    • Possible lower costs relative to out-of-network
    • Contribution to the overall deductible alongside other healthcare expenses

Met

  • Insurance will cover a portion of each session cost, depending on the individual plan
    • Typically, they will cover a percentage; the percentage left over is called “coinsurance”

 

Session costs

The cost of a therapy session depends on a few things:

  • Your individual insurance plan
  • Your provider's training
  • Location
  • Session length

We use your insurance information to calculate your out-of-pocket price per session. You won’t be billed until after your session.

Pricing is calculated based on current plan details on file. The expected session cost (based on average session type and length) will be displayed to both the client and the provider within their respective accounts, as well as in appointment reminder emails to clients.

 

Keeping insurance details up to date

If your insurance plan is about to expire, it’s important to ensure your plan details are up to date in your Headway account.

If you won’t have insurance coverage after your current plan ends, we recommend that you discuss private pay directly with your provider.

To avoid any additional charges, please be sure to always have either an active insurance plan on Headway or opt into private pay with your provider. Beginning June 1 2024, sessions held without active insurance will be automatically charged for the full cost of care*.

* "Full cost of care" is defined as the cost that your insurance carrier determined is the client's responsibility for sessions. You can confirm this cost through the Explanation of Benefits (EOB) provided by your insurance carrier.

Prior authorization

Prior authorization refers to a requirement by health plans for clients to obtain approval of a health care service or medication before the care is provided. Sometimes you may also see prior authorization referred to as prior approval or precertification.

Headway's support team can provide guidance on obtaining instructions for submitting prior authorization requests, but providers must directly submit requests to the insurer due to the required clinical knowledge. Our team can then add the authorization to the client's account so that sessions can be held. 

If you'd like to check on prior authorization, reach out to our support team with the following information: 

  • Anticipated date of service
  • CPT code(s) you intend to use
  • Number of units per CPT code
  • Anticipated ICD-10(s)

Note: Prior authorization is not required on every plan. If you think prior authorization might be required on your plan, or your client's plan, you can submit a manual verification request. 

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