Your Frequently Asked Questions, Answered

At Olive Tree Psychology Clinic, we accept: Aetna, CareFirst BlueCross BlueShield HMO, Care First BlueCross BlueShield PPO, Horizon Blue Cross and Blue Shield of New Jersey, Kaiser Permanente of the Mid Atlantic, and Quest Behavioral Health.

The core benefits of paying out-of-pocket stem from eliminating the interference of a third-party (the insurance company) in your mental health care.

• Confidentiality & privacy: Your therapy records, treatment plans, and progress notes remain confidential between you and your therapist.

• Flexibility in Care: You and your therapist decide the length, frequency, and type of treatment based solely on your clinical needs.

• Wider Selection: You are not restricted to a network, allowing you to choose from a broader range of specialists, particularly those with niche expertise or who are highly experienced.

• No Mandated Diagnosis: A diagnosis is often not required, preventing a formal mental health label from being permanently recorded in your medical history.

What is the primary advantage of using in-network benefits?’

The primary advantage of using your in-network benefits is financial:

• Significantly Lower Upfront Cost: After meeting your deductible, you typically only pay a smaller copay or coinsurance amount per session, making therapy much more affordable.

• Ease of Payment: The therapist's office handles all the billing and administrative work with the insurance company for you.

What are the limitations for In-Network Insurance?

• Shared Information: Insurance companies require access to your diagnosis (which becomes part of your permanent medical record), treatment plans, and notes to approve and pay for services.

• Restricted Treatment: Care is limited to what the insurance company deems "medically necessary," often limiting the number of sessions, duration of care, or type of therapy.

• Limited Network: You can only see the providers who have contracted with your specific insurance plan, which may exclude certain specialists or highly sought-after clinicians.

• Diagnosis Required: A formal mental health diagnosis is typically required to justify and approve payment for treatment.

Many clients use a hybrid approach by utilizing their Out-of-Network (OON) benefits.

• You pay the therapist's full fee upfront (out-of-pocket).

• The therapist provides you with a document called a superbill (like a detailed receipt).

• You submit the superbill to your insurance company for partial reimbursement.

This option allows you to receive a financial offset while retaining most of the advantages of privacy, choice, and control over your treatment. Your insurance provider will usually reimburse a percentage of the cost, often between 50% and 80%, depending on your plan.

• Choose Private Pay if: You prioritize maximum privacy, have a high security clearance, or want a specialized approach not covered by insurance.

• Choose In-Network if: You want to minimize out-of-pocket costs and don't mind a diagnosis being shared with your provider.

• Choose Out-of-Network if: You found the "perfect fit" therapist but they aren't on your plan, and you have PPO benefits.