Consolidated Health Plan (Wellfleet)

One of the barriers to mental health is confusion navigating the process of copays, deductibles, and reimbursement. We’re setting out to demystify the insurance process by answering your questions about using Consolidated Health Plan insurance for behavioral health!

Note: On July 1, 2019, CHP Student Health will become Wellfleet Student Health.

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What does Consolidated Health Plan Cover for Therapy?

Does Consolidated Health Plan pay for therapy?

Yes, CHP does usually cover therapy for mental health and substance use issues, but the exact coverage depends on your specific plan. To find therapy providers in the network that your particular plan uses, look for the network logo on your ID card or plan documentation. Then, you can look up providers by finding your network logo here.

Does Consolidated Health Plan cover online therapy?

Again, your coverage will depend on the details of your plan. Online sessions can be a convenient alternative to in-person visits and can also help you manage medication without visiting your therapist’s office. To find out whether your plan covers online therapy, you can contact customer service or refer to your plan documents.

What kind of coverage does Consolidated Health Plan offer for mental health?

CHP covers a variety of mental health treatments and conditions, but the specifics vary from plan to plan. The easiest way to find out what kind of coverage you have is to contact member services via the phone number on your insurance card.  If you have CHP through a college or university plan, it may also help to first consult with your campus wellness center. They may be able to guide you through your health care plan, including benefits and coverage. Some campus wellness centers also offer free mental health treatment outside of your insurance coverage.

How much does Consolidated Health Plan reimburse for therapy?

Reimbursement rates under CHP vary across different plans, though most plans are similar in that they have different rates for therapists who are in-network with CHP, as opposed to those who are out of network. For more details, check your plan, and be sure that you understand how much you’ll be responsible for paying before you make your first therapy appointment.

How much are therapy sessions under a Consolidated Health Plan insurance plan?

Costs for therapy sessions will vary from plan to plan. Check your plan documents for information about treatment coverage. If you have CHP through a college or university plan, your campus wellness center can also help you find more information about costs before you commit to therapy.

What is my copay for therapy with Consolidated Health Plan?

Most CHP plans have a copay – that is, a preset amount you pay for for covered health services at the time you receive care – but the amount of your copay depends on the details of your specific plan. Although you will not pay a copay when you use a doctor or facility that is out-of-network, you are responsible for paying a percentage of the total bill – the coinsurance. Coinsurance is usually much more expensive than an in-network copay.

If you have CHP through a college or university plan, copay are often relatively low. You can speak to someone at your campus wellness center for more information about how much your copay is likely to be.

What is my deductible for therapy with Consolidated Health Plan?

Deductibles vary widely between plans. Usually, you’ll choose your overall plan deductible when you sign up for insurance. Consult your specific plan documents for details.

What happens if I don’t use a Consolidated Health Plan therapist?

If you see a therapist who is not in-network with CHP, you may still be able to get reimbursed for out-of-network benefits. This is not always the case, so be sure to check your plan documents and speak with member services if need be. It is often necessary to pay out of pocket for sessions with an out-of-network therapists. When you speak to CHP about out-of-network benefits, be sure to ask the following:

  • What is my annual deductible?

  • Do I have an additional out-of-network deductible?

  • What is my coinsurance for outpatient mental health?

  • Do I need a referral from a primary care physician or an in-network therapist to see an out-of-network therapist?

  • How do I submit out-of-network claims for reimbursement?

Claims and Reimbursements for Consolidated Health Plan

How long do you have to submit a health insurance claim with Consolidated Health Plan?

CHP does not specify an exact time frame for submitting claims, but rather asks that you submit a claim “as soon as reasonably possible.” It’s best to send your claims as soon as you can. You can find more information about submitting claims with CHP here.

How do I complete Consolidated Health Plan claims for therapy?

You can obtain a claim form from your college or university, or else online on the CHP website. Once you have completed the form, you should send it to CHP by mail along with itemized bills or receipts for your treatment. Complete instructions are available here.

What is the Consolidated Health Plan claims address?

You can mail your completed CHP claims to:

Consolidated Health Plans

2077 Roosevelt Avenue

Springfield, MA 01104

What is the number for Consolidated Health Plan?  

You can reach CHP by calling the number on your insurance card or at 877-657-5044.

How should I get therapy if I don’t have insurance?  

If you want to find a therapist but don’t have insurance, you can visit Zencare’s search page to look for therapists who have sliding scale fee options or who offer sessions within your price range.

How can I find Consolidated Health Plan therapists?

If you’re in New York City or Rhode Island, you can find vetted CHP Behavioral Health providers on Zencare. Select Consolidated Health Plan as your insurance company under "Payment Options" to view therapists who are in-network, or click the links below.

Visit therapists’ profiles to watch an introductory video, check up-to-date availability, and book a free initial call to find the right therapist for you.

Outside of those areas? Remember that under CHP, different providers are in-network with different specific CHP networks. To find therapy providers in the network that your particular plan uses, look for the network logo on your ID card or plan documentation. Then, you can look up providers by finding your network logo here and clicking through to see options in your area. Note, however, that information there is often out of date. Reach out to multiple therapists, and don’t be discouraged!