Independence Blue Cross for Therapy

Independence Blue Cross is an insurance company based out of Philadelphia that provides individuals, families, and employers with health insurance plans. They also provide Medicaid and Medicare plans. Independence Blue Cross believes in whole-person care, which is why they offer mental health benefits for their members.

Does Independence Blue Cross cover therapy?

Yes, Independence Blue Cross provides its members with mental health benefits, meaning that you don’t need to completely pay out-of-pocket for sessions with a licensed therapist. The most cost-effective way of using your Independence Blue Cross plan to lower your overall costs is to work with an in-network therapist, rather than working with an out-of-network therapist.

Independence Blue Cross offers many different types of plans, and the amount of coverage provided to you for mental health services depends on your specific plan. Because of this, it’s important to understand the specific details of your plan before you start therapy. That way, you can avoid unnecessary costs or surprises.

How do I check if my Independence Blue Cross plan covers therapy?

To check if your Independence Blue Cross plan covers therapy services, locate your plan’s Summary of Benefits and Coverage document. This document gives you the details about how much coverage your Independence Blue Cross plan offers you by service type. You can find this document through your online Independence Blue Cross online account or if you receive Independence Blue Cross as a benefit from your workplace, you can get it from your HR team.

Within the Summary of Benefits of Coverage document, located the line that’s called “If you need mental health, behavioral health, or substance abuse services.” Look next under “Outpatient services” to see what your plan offers in terms of coverage for therapy sessions. You’ll see these costs broken down into in-network and out-of-network, with different coverage rates for each one.

Insurance benefits can be complicated and difficult to understand. If you need to speak with someone, give the number on the back of your Independence Blue Cross insurance card a call and ask them about the out-of-pocket costs for outpatient mental health services.

How much does therapy cost with my Independence Blue Cross plan?

The exact costs of therapy will vary based on which Independence Blue Cross plan you have, as there are many different plans offered through Independence Blue Cross. This includes different copays and coinsurances.

As an example of the mental health benefits from the Independence Blue Cross Personal Choice PPO Gold plan, to see an in-network therapist can cost you a $65 copay per session and a 50% coinsurance per session with an out-of-network therapist. This means that you’ll pay for half of the session fee — if your therapist’s session fee is $250, you’ll need to pay $125 out of your own pocket.

Independence Blue Cross also offers its members a no or low-cost option for mental health services called Quartet. Quartet is an online platform where members can find psychoeducation about different mental health topics as well as connect with a therapist or a psychiatrist.

What types of mental health conditions does Independence Blue Cross cover?

Independence Blue Cross covers therapy services for many different mental health conditions and life situations. When seeing a therapist through Quartet, you might not need to receive a diagnosis to continue your relationship with your therapist. However, when working with a therapist outside of this platform, you may need to receive a diagnosis from your therapist. This information is needed to start your billing or reimbursement process.

Common mental health diagnoses include:

These, and many more diagnoses, are eligible for coverage through Independence Blue Cross.

What types of therapy does Independence Blue Cross cover?

Your therapist must be a credentialed and licensed mental health professional for their services to be eligible for your Independence Blue Cross coverage. Your therapist might be a psychologist, psychiatrist, social worker, licensed professional counselor, nurse practitioner, or any other professional field in mental health. Your therapist must also use an evidence-based therapy approach, which means that there is clinical research that demonstrates its efficacy when treating your mental health diagnosis.

Some examples of evidence-based therapy approaches include:

Your therapist may blend therapy approaches to offer you more individualized care.

What types of therapy does Independence Blue Cross NOT cover?

Independence Blue Cross plans do not offer mental health benefits for types of therapy that lack clinical rigor. This includes career counseling and life coaching. While these therapy modalities are helpful for many people, they are excluded from coverage because they have yet to receive research findings that support their efficacy. However, your therapist may incorporate elements of career counseling or life coaching into your sessions while also offering your evidence-based approaches.

Independence Blue Cross plans also do not cover holistic therapies like nutritional therapy, aromatherapy, massage therapy, acupuncture, or reiki healing.

Does Independence Blue Cross cover online therapy?

Yes, Independence Blue Cross offers mental health benefits for online sessions with your therapist. This is especially true when you engage Quartet for therapy or other mental health resources.

For individuals who want to use their Independence Blue Cross benefits to work with an online therapist, they’ll pay the same amount they would normally pay when seeing a therapist in-person, including the same copay or coinsurance rates.

Does Independence Blue Cross cover couples therapy?

Independence Blue Cross does not cover couples therapy. Couples therapy is generally not covered by insurance plans and Independence Blue Cross is no different. This is because insurance requires your therapist to report a diagnosis to receive coverage, and this is challenging for couples.

However, there are other options to leverage if you still want to work with a couples therapist, meaning that you can still grow your relationship or overcome conflicts together.

Do I need to see my primary doctor before starting therapy?

Independence Blue Cross offers both HMO or PPO plans. If your Independence Blue Cross plan is an HMO, then you will need to see your primary doctor before starting therapy. This is because you need a referral in order to access your insurance benefits, as therapists are considered specialists. If your Independence Blue Cross plan is a PPO, however, you do not need this referral and can begin working with a therapist right away.