Multiplan or PHCS | Mental Health Coverage | Zencare — Zencare
private healthcare systems (phcs) is a health insurance company that offers millions of members nationwide coverage for medical and behavioral health care. They partner with Multiplan to access their PPO network. many therapists are part of the multi-plan network and take out phcs insurance to make mental health care more affordable for clients.
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does phc cover the therapy?
yes, phcs does provide coverage for therapy services. members of phcs health insurance plans have mental health benefits, which vary depending on the plan in which they are enrolled. Phcs is a large health insurance company with a wide range of plan types, so the amount of coverage varies. however, most phcs plans offer members coverage for the costs of therapy. Seeing an in-network therapist with multiplan is the most affordable option, as seeing an out-of-network therapist may cost more.
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how do i check if my phcs plan covers the therapy?
To check if your phcs health insurance plan offers coverage for mental health services such as therapy, look for your summary and benefits document. This document lists how much your responsibility is based on the type of service. look for the line “outpatient mental health services” or “mental/behavioral health outpatient”; here you will find a copay or coinsurance rate. You will find your summary and benefits document through your online phcs portal.
You can also call the phcs customer service hotline to confirm your mental health benefits. you can find this phone number on the back of your insurance card.
how much does therapy cost with my phcs plan?
While coverage depends on your specific plan, expect to pay around $20 copay per visit with a multi-plan provider or 20% coinsurance per visit with an out-of-network therapist. this fee may be different depending on your plan, so it’s important to determine the exact fees before you start seeing a therapist.
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If you are concerned about paying for therapy, ask your therapist about sliding scale options. If your therapist offers sliding scale payments, you may be eligible to pay a reduced fee per session.
what types of mental health conditions does phcs cover?
phcs health insurance covers services for many mental health conditions. To reimburse therapists or clients, Phcs requires that the client receive a diagnosis from their therapist. this diagnosis guides treatment and insurance coverage.
some mental health conditions covered by phcs include:
- depression
- anxiety
- eating disorders
- adhd
- substance abuse
- ptsd
- cognitive behavioral therapy (cBT)
- dialectical behavior therapy (dtb)
- eye movement desensitization and reprocessing (EMDR)
- mindfulness practices
- parent-child psychotherapy
- acceptance and commitment therapy (ACT)
what types of therapy does phcs cover?
phcs requires a licensed therapist to provide clinically rigorous evidence-based therapy to be eligible for reimbursement.
These evidence-based therapy modalities include:
there are many more types of therapies, and therapists often combine modalities in their own approaches, all of which are covered by phcs.
what types of therapy are not covered by phcs?
phcs does not cover life coaching or career counseling; This is because coaching is generally goal-based and not diagnosis-based. magellan health also does not provide coverage for holistic treatment modalities such as aromatherapy or massage therapy. it does not cover energy work such as reiki healing.
does phc cover online therapy?
yes, phcs covers online therapy services. many clients prefer to see their therapists online through a secure online platform as it makes mental health treatment convenient and more accessible. phcs offers the same coverage and benefits for online therapy and in-person therapy.
does phc cover couples therapy?
Most phcs health plans do not cover couples therapy. check with your specific plan to see if seeing a couples therapist will be reimbursable.
if your phcs health insurance benefits don’t cover couples therapy, but you’re still interested in working with a couples therapist, there are many ways to make couples therapy more affordable.
Do I need to see my GP before starting therapy?
Because pchs is a ppo plan (using multiplan as the ppo provider network), you don’t need a referral from your primary care doctor before you begin your search for a great therapist. this will save you time and also open doors for you to start your mental health journey with a therapist who is perfect for you.
Source: https://amajon.asia
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