Insurance

When seeking therapy benefits, there are some important questions to ask your insurance carrier. Here are some key questions to consider when understanding your insurance and the process associated with insurance coverage.

  • Are we in-network or out-of-network with your insurance carrier?
  • Do I have a prescription from my child’s primary care physician or medical specialist? If so, has my insurance confirmed that therapy services are covered under my plan?
  • Does my insurance cover applied behavior analysis?
    • Be sure to acquire the proper benefits: they can vary greatly.
  • Does my plan renew yearly on January 1 or does it renew when my plan was first acquired?
  • Is there a visit limit set depending on the discipline? Is the visit limit for each individual service or are visits combined into one limit?
  • Does my insurance have any restrictions as to what they will and will not cover? If your child has a specific diagnosis, such as Autism, it is important to provide that diagnosis to your insurance company to confirm it is covered as many plans do not allow coverage for developmental delays. Most plans only cover applied behavior analysis when provided with a specific diagnosis of Autism.
  • Does my insurance have a deductible? How much? Do I have a copay or a coinsurance? What are the specifics?
  • Does my plan require prior authorization for services? If yes, does my child’s pediatrician or therapy provider acquire this?

Maneuvering through the world of insurance can be a tricky process, but we are here to help and guide you through. While we will always do everything we can to work with you, it is important to remember even though your insurance may offer coverage for specific therapy service, this is not a guarantee of payment.

Personal Growth Services can not ensure that your insurance will pay for your services. If your insurance does not cover services, we offer a Private Pay option and are willing to work with families on an individual basis. Please note that insurance does not cover our mentor services.