First Choice Health Therapy Coverage

First Choice Health Therapy Coverage

First Choice Health offers plans to cover a range of mental health conditions. Your insurance summary of benefits will list the items covered under your particular plan. This often includes treatment for:

• Substance abuse
• Anxiety
• Depression
• Eating disorders
• ADHD

If you are seeking coverage for a mental health condition, your insurance provider will require that your assigned therapist give you a legitimate diagnosis of at least one mental health condition and share that diagnosis with the insurance provider in order to apply benefits to your treatment. You may also work with a primary care physician to get a diagnosis before starting treatment with a therapist. 

First Choice Health offers coverage for mental health and addiction treatment. However, the cost of that treatment will vary based on factors like:

• The plan you have
• Your deductible
• Whether you choose to work with someone who is in-network or not

You can review your plan, summary of benefits, and deductibles on your health insurance card by contacting your health insurance representative through the number on the back of your card or reaching out to our team and letting us help.

Plan Type

First Choice Health offers many insurance plans, especially for self-funded employers. Your plan might be one of the following:

• PPO
• EAP
• Medical Management Plan
• HSA
• Group Plan
• Individual Plan

Individual plans like short-term and major medical policies can be a good way to get coverage if you are in between jobs, but you might have an insurance policy provided for you by your clinically integrated network or employer. 

Deductible

Knowing which plan you have is important because your deductible will change based on the type of plan you have and the premiums you pay.

The deductible refers to the amount of money you have to pay out of pocket every year before your insurance will apply some of the benefits. You might, for example, be required to meet your deductible before your insurance company will cover the cost of inpatient addiction treatment. 

Co-pays/Coinsurance

Similarly, the plan you have will also determine what your co-pays are or if you have coinsurance requirements that you have to meet.

In-Network vs. Out-of-Network

You can choose to see a therapist or receive treatment from a treatment center that is in-network or out-of-network. 

An in-network provider will typically have lower co-pays and other costs because your insurance company already has an agreement with that therapist or that treatment center for the cost of services.

Types of Therapy Under First Choice Health Therapy Coverage

First Choice Health therapy coverage applies to many of the modalities used at Skycloud. 

Cognitive Behavioral Therapy

At Skycloud, we offer cognitive behavioral therapy specifically for a wide range of conditions, including:

• PTSD
• Anxiety
• Depression
• Substance abuse

Cognitive behavioral therapy can help enhance your coping skills by promoting healthier thoughts, actions, and relationships. The idea behind cognitive behavioral therapy is that your thoughts directly influence your emotions, and these directly influence your behaviors.

However, many people have adopted automatic, negative thoughts or beliefs that are often incorrect or unrealistic. Without learning to identify these negative thoughts or catching them, individuals struggle with subsequent negative emotions and behaviors.

The right type of individual and group therapy can help you catch those thoughts, challenge them, and change them. This can also help you learn effective coping mechanisms for handling difficult situations or challenging emotions.

Dialectical Behavioral Therapy

Another key modality offered at Skycloud is dialectical behavioral therapy. Building on the principles of cognitive behavioral therapy, this focuses more on crafting distress tolerance, learning to be more mindful of your thoughts and the things around you without judgment, and learning to use healthy coping mechanisms instead of unhealthy behaviors.

Dialectical behavioral therapy can help you challenge your emotional responses and help you better manage your emotions. All of this can improve communication, social skills, and relationships by reducing your self-destructive behaviors and living a life that is meaningful.

Costs for Therapy with First Choice Health Benefits

If you are trying to get there before a mental health disorder or treatment for addiction, the cost you have to cover out of pocket is based on the benefits of your plan and whether the treatment you receive is from a qualifying in-network provider or not.

In general, you might be responsible for meeting your full deductible before your insurance will cover therapy sessions. If you have a coinsurance fee, that is a set fee typically between $15 and $50 that you have to pay for every therapy session after you have met your deductible.

If you see an in-network provider for addiction treatment or mental health treatment, you will be required to pay coinsurance or payments on your deductible, but if you see someone who is out-of-network, you may likely get reimbursed for only a portion of the fee. 

Find The Help You Need

No matter the plan you have, you can apply First Choice Health therapy coverage or First Choice Health addiction treatment coverage benefits. Don’t wait to get help; see what your insurance can do to reduce the cost of getting treatment immediately. 

Call our team at (503) 967-2476 to review your benefits and get treatment today. 

FAQ

Is Virtual Therapy Covered with First Choice Health?

Yes, with some plans, this is covered. Some plans have 24/7 access to virtual therapy with no additional cost, as well as lower costs if you choose a virtual therapist who is in-network, compared to in-person services. 

How Do I Find In-Network Therapists?

First Choice has a Behavioral Health Directory. This is a directory of all Behavioral Health Providers that are qualifying in-network therapists. You can use this directory to find covered services, reach out to Skycloud directly, or call your insurance company. 

Are There Things First Choice Health Won’t Cover?

Most of the time, if you participate in therapy outside of a licensed professional and their office, like career or life coaching, these forms of support are not covered. First Choice Health also does not cover couples counseling. 

Does First Choice Health Cover Online Therapy?

Yes, if you have First Choice Health insurance, you can get coverage for certain things with online therapy. This is based on the type of plan you have, though, and it is important to review your benefits to confirm whether this applies to your situation. Our team can help you verify your coverage when you reach out for an appointment. 

Do I Need a Referral to Start Therapy with First Choice Health?

No, with a PPO plan, you do not need a referral to start your therapy. Bear in mind that visiting a therapist outside of your insurance network, though, could come at an extra cost. To make sure you are working with an in-network professional, call our team today to verify your benefits.