To use your Medicare benefits, Medicare requires that you are seen by an in-network Medicare provider.
We accept the following Types of Medicare Plans:
- Straight Medicare
- Medicare Advantage (Complete) Plans: Medicare Advantage plans cover everything original Medicare covers and generally offers extra benefits (Part B – for mental health).
- Medicare Supplemental (Medigap) Plans: Medicare Supplemental Insurance is a plan that you buy from a private insurance company that pays for some of the cost sharing in Medicare. Medicare sends claims directly to them for processing if the client has coordinated their benefits.
Our Medicare providers are not in-network with all Advantage or Supplemental plans and recommend you contact your insurance plan to understand what is covered and that your provider will be covered in-network. Customer Service numbers are located on the back of your insurance card.
*Please note, we do NOT accept: Medicaid, Medicare (Capitated or DNSP), Molina, DSHS, Washington Apple Health, state-supplemented insurance plans, Community Health Plan of Washington or Labor and Industry claims.
Medicare Part B: Covers Counseling and Psychotherapy services to treat mental health issues including:
- Individual Counseling.
- Family Counseling (Medicare covers family counseling when the goal of the therapy is related to your treatment).
If you have questions about Medicare coverage, please call them directly at 1-800-633-4227 or visit www.medicare.gov.
Medicare Scenarios
- If you are on disability or 65+ and have Medicare as a Secondary insurance, your group health plan generally pays first and if you have you have coordinated your benefits then Medicare can be billed for your remainder (you would still need to be seen by an in-network Medicare provider to use this benefit). That said, you’ll have to pay any costs Medicare or the group health plan doesn’t cover.
- If you are 65+ and work for a company that has 20+ employees, your group health plan generally pays first and (you would still need to be seen by an in-network Medicare provider to use this benefit) if you have you have coordinated your benefits then Medicare can be billed for your remainder That said, you’ll have to pay any costs Medicare or the group health plan doesn’t cover.
- When you have Medicare as Primary with a Supplement or Secondary Plan: When you have insurance coverage including a Medicare plan, claims can only be processed through Medicare when you are seen by an in-network Medicare provider. Claims submitted by a non-in network provider will be rejected by Medicare therefore any secondary plan would not be able to process.