QUESTIONS ABOUT INSURANCE

Click on a topic below for help with commonly asked questions.

What insurances do you accept?

We are in-network providers on the following panels:

• Aetna (Aexcel, Healthfund, Open Access plans, Standard plans, Student Health plans, Affordable Health Choices.)
  • Do NOT accept Aetna Trinity
• Aetna Medicare (ONLY if booked with LISW, LISW-S, PhD, PsyD, CNP or MD)​
• Choicecare
• Cigna/Cigna EAP​
• Cofinity
• First Health (Optima Health)
• Health Smart
• HealthReach Preferred (OhioHealthy)​
• Humana (but NOT Humana Medicaid)
• Humana Medicare (ONLY if booked withLISW, LISW-S, PhD, PsyD, CNP or MD)
• MedBen
• Medical Mutual of Ohio
  • No NOT accept HMO Medflex
• Medical Mutual Medicare Advantage ​(ONLY if booked with LISW, LISW-S, PhD, PsyD, CNP or MD)
• Meritain
• Ohio Health Choice
• Ohio PPO Connect
• Optima​ (OhioHealthy)
• ​Optum​​
• OSU employee insurance may be used at our Westerville location ONLY
  • We are NOT CONTRACTED with OSU insurance but you can access your benefits using the Ohio Health Choice network for providers located at our Westerville office ONLY. (Coinsurance may be different than what you typically pay with OSU network providers.) 
• OSU student insurance may be used at our Westerville location ONLY
  • ​​We are NOT CONTRACTED with OSU insurance but you can access your benefits using the UHC network for providers located at our Westerville office ONLY. (Copay may be different than what you typically pay with OSU network providers.) 
• Tricare (certified provider-out of network benefits/deductible apply; no PCP referral needed)
  • ​​Dr Churchill does NOT accept Tricare
• UBH/UMR/UHC/UBH EAP 
  • UHC for OSU Student plan accepted by Westerville providers ONLY
  • Do NOT accept UHC Medicare
  • Do NOT accept UHC Community/Medicaid)
  • Dr. Churchill does NOT accept UBH/UHC/UMR/UBH EAP

*We do NOT accept Anthem, Blue Cross Blue Shield, Aetna Trinity Plan, Medicaid, UHC Community Plan, Caresource, Molina, straight Medicare, or dual Medicare/Medicaid policies. If you register with one of these policies/plans, you will be self-pay.

If we are not currently in-network for your insurance, call your insurance provider directly to find out your out-of-network benefits.
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Have more questions about insurance? Please fill out the form at the bottom of the page so we can further assist you.

Will my insurance cover telehealth?

Prior to COVID-19, some insurance companies covered telehealth on a limited basis but many did not. Due to the quarantine, many insurance companies developed or relaxed requirements on telehealth to make it easier for patients to get the help they needed. Now that the quarantine is lifting, insurance companies are restructuring how they handle telehealth visits going forward. Each insurance company is doing things slightly differently, and when we call to get verification, we are frequently given contradictory information. 

WHAT DOES THIS MEAN FOR YOU?
Call the Member Services number on the back of your insurance card to get clarification about whether or not your virtual visits will be covered and at what cost to you.  If your insurance will no longer cover telehealth services, please discuss this with your therapist to come up with a plan.

WILL I HAVE TO PAY MORE?
Certain insurance companies are covering the full cost of telehealth. If you are seen in the office, certain insurance companies will require you to pay your usual copay. Because costs vary so widely across plans and insurance companies, it is best for you to call your insurance to check in advance of your session what your out of pocket cost will be. When you call, always get a reference number for your call. 

WHAt is a Deductible?

A deductible is the amount you pay before your insurance company begins paying. For example, if you have a $2000 deductible, the first $2000 of charges will be your responsibility. After the deductible is met, your plan will begin paying at the level determined in your policy, which may include a co-insurance. (Your plan may or may not have a deductible. Check your benefit documents, call the number on your insurance card or talk to your HR department.)

What is co-insurance?

After the deductible is met, some plans have a co-insurance, which is a shared cost of services between the patient and the insurance company. For example, if you have 80/20 coinsurance, insurance will bay 80% of the cost and you will be responsible for 20%. (Your plan may or may not have co-insurance. Some plans have copays instead and some pay in full after the deductible is met. Check your benefit documents, call the number on your insurance card or talk to your HR department.)

What is a copay?

Instead of co-insurance, some policies have a copay. A copay (or copayment) is a fixed amount you pay per visit and can range from $10-$70. The exact amount will depend on your individual policy and whether your insurance has us listed as a specialist or general practitioner.  Generally, if your insurance recognizes behavioral health as specialists, your co-pay will be higher.  (Your plan may or may not have a copay and the amount varies by policy. Some plans have co-insurance instead and some pay in full after the deductible is met. Check your benefit documents, call the number on your insurance card or talk to your HR department.)

What is an out-of-pocket max?

Most plans have a maximum amount that you have to pay per benefit year. Once you reach this amount, the insurance company pays all services beyond it in full for the remainder of the benefit year (up to a benefit max, if applicable.) For instance, if you have a $5000 out of pocket max, and you have a few procedures or ER visits that total $5000, your insurance company will cover any additional services you receive for the remainder of the benefit year. (To find out the amount of your out-of-pocket maximum, check your benefit documents, call the number on your insurance card or talk to your HR department.)

how much is my deductible, co-insurance and/or copay?

It depends on your individual insurance policy and varies by plan. To find out your benefits, check your benefit documents, call the number on your insurance card or talk to your HR department.

How much will I have to pay at the time of the appointment?

​The amount depends on your insurance plan (see deductible, co-insurance, copay above.) Unless you have made payment plan arrangements with our billing manager, the entire balance of your visit is due at the time of service. We accept only credit cards. Payments accepted include: HSA, Visa, Mastercard, Discover and American Express

HOw Do I contact my insurance company or the Ohio Department of insurance?

Questions about your specific policy, benefits, coverage, in-network providers or claims payments should be directed to the member/customer service number on the back of your insurance card.
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To better understand health insurance in general, or for complaints about insurance companies, call The Ohio Department of Insurance at 800-686-1526

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