Understanding client benefits

Updated

Each individual plan works differently — you can find your detailed benefits in your account. Here’s a rundown of some of the common terms you’ll see explaining your benefits:

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 each of you.

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.

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.

Out-of-Pocket Max

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.

 

Updating or adding insurance information

To manage your insurance details, log in to your account, click your initials in the top right corner, and select Benefits from the dropdown menu.

Depending on your situation, follow the steps below:
 

Option 1: Same insurance carrier, new member ID

  1. Remove your current insurance information
  2. Add your new details immediately, to prevent billing issues
  3. We will recalculate your benefits and notify you of any changes to your cost estimate
     

Option 2: New insurance carrier

  1. Remove your current insurance information
  2. Add your new details immediately, to prevent billing issues
  3. We will calculate your new benefits and provide a cost estimate 
  4. Confirm that your current therapist accepts this new plan; you can check on this by: 
    • Looking on your provider’s Headway profile
    • Messaging your provider directly

We’re also happy to help you figure any of this out with you. Just send us a message!

Disclaimer: This document is for educational purposes only and is not intended as professional or legal advice. It may contain errors or missing information, and recent changes in policies, regulations, or payer requirements may not be reflected. Because requirements vary by organization and jurisdiction, please consult legal counsel, the appropriate regulatory or licensing authority or your designated Headway contact for guidance specific to your situation.

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