Does insurance cover psychiatric care? Aetna, Cigna and Optum explained
How insurance coverage works for psychiatric visits, which plans we’re in network with, and how to use out-of-network benefits.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
Most health plans cover mental health care, thanks in part to federal mental health parity laws. But the details can be confusing. Here’s how to make sense of your coverage.
Plans we’re in network with
Wellthy is in network with Aetna, Anthem Blue Cross California, Carelon Behavioral Health, Cigna, Oxford / Optum, Quest Behavioral Health and United Healthcare / Optum.
What you might pay
Your cost depends on your plan’s copay, coinsurance and deductible. Call the member services number on your insurance card and ask about outpatient mental health benefits with a psychiatric nurse practitioner, both in person and by telehealth.
Questions to ask your insurer
Is outpatient mental health care covered?
What’s my copay or coinsurance per visit?
Have I met my deductible this year?
Do I need prior authorization or a referral?
Are telehealth visits covered the same way?
Using out-of-network benefits
If you have a PPO plan we’re not in network with, we can provide superbills you can submit to your insurer for possible reimbursement.
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