Climbing Together, Healing Stronger, Rising Unstoppable
- info@araratpsychiatry.com
- (305) 615-5145
Our team works closely with patients and insurance providers to verify benefits, explain coverage, and minimize out-of-pocket costs. For those without insurance, we also offer self-pay options to ensure that every individual has access to the care they need. If you have questions about your specific plan or coverage, our office is happy to assist you.
We work with a variety of insurance plans to help make mental health care more accessible and affordable. Coverage and benefits may vary, so we encourage you to contact your insurance provider to confirm eligibility, coverage details, and any out-of-pocket costs prior to your appointment.
Health insurance can feel overwhelming, but understanding a few key terms can make it much easier to navigate. Below is a brief explanation of commonly used insurance terms. For specific costs related to your plan, we recommend contacting your insurance provider directly.
You may hear phrases like “your visit is covered” or “this service is covered by insurance.” Coverage means that your insurance plan includes the service and will pay for all or part of the cost, depending on your plan benefits.
A copay (or copayment) is a fixed amount you pay at the time of your visit when your insurance is covering the service. Copay amounts vary by plan and may differ depending on the type of service, such as a medical appointment, therapy session, pharmacy visit, or urgent care.
A deductible is the amount you are required to pay out of pocket each year before your insurance begins contributing to covered services. This amount is determined by your specific insurance plan.
Coinsurance is your share of the cost for covered services after your deductible has been met. For example, if your plan covers 80% of a service, you are responsible for the remaining 20%.
A claim is a request for payment sent to your insurance company after you receive care. This is typically submitted by the provider. Once processed, your insurance will determine what they pay and what portion, if any, you are responsible for paying.
An Explanation of Benefits is a statement from your insurance company that outlines how a claim was processed. It shows what was billed, what your insurance paid, and any remaining balance you may owe. If anything is unclear, your insurance company can help explain the details.
Out-of-pocket costs are expenses you pay yourself. These include deductibles, copays, coinsurance, and charges for services not covered by your insurance.
Your out-of-pocket maximum is the highest amount you will pay in a year for covered services. Once this limit is reached, your insurance typically pays 100% of covered costs for the remainder of the year.
A premium is the monthly amount paid to maintain your health insurance coverage. This may be paid by you, your employer, or both.
