Insurance Coverage
At Primary Care Psychology Associates, LLC pride ourselves with offering excellent psychological services to patients covered by the most popular insurance plans.
Our clinical staff are currently in-network with the following insurance providers:
Aetna
Blue Cross/Blue Shield PPO
Blue Cross/Blue Shield Northwestern Medicine PP HMO
Cigna
Cigna Great West
Medicare
United Behavioral Health / Optum
PsycHealth
Sliding scale fee for services may be available to patients who have out-of-network insurance plans depending on clinician availability.
For additional questions regarding insurance coverage and cost of services, please reach out directly to your insurance provider.
At Primary Care Psychology Associates, LLC pride ourselves with offering excellent psychological services to patients covered by the most popular insurance plans.
Our clinical staff are currently in-network with the following insurance providers:
Aetna
Blue Cross/Blue Shield PPO
Blue Cross/Blue Shield Northwestern Medicine PP HMO
Cigna
Cigna Great West
Medicare
United Behavioral Health / Optum
PsycHealth
Sliding scale fee for services may be available to patients who have out-of-network insurance plans depending on clinician availability.
For additional questions regarding insurance coverage and cost of services, please reach out directly to your insurance provider.
Insurance FAQ’s and Definitions
How Does Your Deductible Work?
If a health insurance policy includes a deductible, then the insured must pay a certain amount of money toward his/her health care before the insurance company is required to pay anything under the policy. For example, if an insured has a $1,000 deductible toward his/her psychotherapy or testing services, then he/she is responsible for paying the first $1,000 of health care costs incurred. After he/she pays the first $1,000, then the insurance company will begin paying toward health care costs as specified under the terms of the policy. After an EOB (Explanation Of Benefits) is returned to PCPA confirming the amount to be applied towards the deductible, an invoice for the balance due will be sent to the patient.
How Does Your Co-pay Work?
A co-pay is a flat payment that is due at the time of a doctor visit, including treatment and testing. The co-pay is collected at the time of service and is the responsibility of the patient. A co-pay is processed at the time of service.
How Does Your Co-Insurance Work?
Like a co-pay, co-insurance is the responsibility of the patient. Co-insurance may represent 10% or 20% of the doctor’s fee that must be paid by the patient after meeting a deductible (if applicable). There is usually a maximum out-of-pocket limit, such as $1,000, $2,000 or higher that is the maximum a member can pay prior to the plan paying 100% during a calendar or benefit year. Copays, however, do not always count toward the out-of-pocket limit. Your co-insurance balance may not be known until an overall estimate of benefits is received. Therefore, co-insurance fees due will be billed sometime after time of service.
How Does Your Deductible Work?
If a health insurance policy includes a deductible, then the insured must pay a certain amount of money toward his/her health care before the insurance company is required to pay anything under the policy. For example, if an insured has a $1,000 deductible toward his/her psychotherapy or testing services, then he/she is responsible for paying the first $1,000 of health care costs incurred. After he/she pays the first $1,000, then the insurance company will begin paying toward health care costs as specified under the terms of the policy. After an EOB (Explanation Of Benefits) is returned to PCPA confirming the amount to be applied towards the deductible, an invoice for the balance due will be sent to the patient.
How Does Your Co-pay Work?
A co-pay is a flat payment that is due at the time of a doctor visit, including treatment and testing. The co-pay is collected at the time of service and is the responsibility of the patient. A co-pay is processed at the time of service.
How Does Your Co-Insurance Work?
Like a co-pay, co-insurance is the responsibility of the patient. Co-insurance may represent 10% or 20% of the doctor’s fee that must be paid by the patient after meeting a deductible (if applicable). There is usually a maximum out-of-pocket limit, such as $1,000, $2,000 or higher that is the maximum a member can pay prior to the plan paying 100% during a calendar or benefit year. Copays, however, do not always count toward the out-of-pocket limit. Your co-insurance balance may not be known until an overall estimate of benefits is received. Therefore, co-insurance fees due will be billed sometime after time of service.
