First Health | Mental Health Coverage | Zencare — Zencare

Introduction to First Health

First Health, a subsidiary of Aetna Inc., is a leading health insurance company with over 5.5 million members. As one of the largest networks in the country, First Health provides its members with access to an extensive network of exceptional therapists nationwide.

Does First Health Cover Therapy?

Yes, First Health does provide coverage for therapy services to its members. However, it’s important to note that as a large health insurance company, First Health offers various plans across the country, and the mental health benefits may vary depending on the specific plan you have.

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For individuals with First Health coverage, seeing a therapist within the First Health network is often the most cost-effective option, resulting in lower out-of-pocket expenses.

Checking Mental Health Coverage in Your First Health Plan

To determine if your First Health plan covers mental health services, refer to your benefits summary and documents either online or in print. Look for the section that outlines the therapy fee under categories like “outpatient mental health” or “outpatient behavioral health” services. Here, you will find details about your copay or coinsurance rates and understand your responsibility regarding session fees.

If you cannot locate your benefit summary and documents, simply contact the customer service hotline number provided on the back of your insurance card. A First Health agent will assist you in obtaining information about your mental health benefits.

Therapy Costs with First Health Plans

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When you consult a therapist within the First Health network, your copay for each session can be around $50, depending on your specific plan. It’s important to remember that First Health offers various plans, which differ based on factors such as family size and geographical location, resulting in varied copay amounts. It’s worth noting that First Health does not cover services from out-of-network therapists.

Mental Health Conditions Covered by First Health

First Health insurance covers services for a wide range of mental health conditions. To receive reimbursement from First Health, the client must receive a diagnosis from their therapist. The diagnosis serves as a guide for treatment and insurance coverage.

Examples of eligible mental health conditions include:

• Depression
• Anxiety and stress
• Alcohol abuse
• Infertility concerns
• Grief and loss
• Eating disorders
• Learning difficulties

Therapy Modalities Covered by First Health

First Health provides coverage for therapy modalities that are clinically rigorous and evidence-based, in line with the client’s specific diagnosis. Some of the evidence-based therapy modalities covered by First Health include:

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Eye Movement Desensitization and Reprocessing (EMDR)
• Mindfulness practices
• Parent-child psychotherapy
• Acceptance and Commitment Therapy (ACT)

Additionally, there are numerous other therapy types, and therapists often combine modalities to create their own unique approaches, all of which are covered by First Health. First Health ensures that its providers possess the necessary credentials and maintains high professional standards.

Therapy Modalities Not Covered by First Health

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While First Health covers a wide range of therapy modalities, there are certain modalities that it does not cover. These include personal counseling, professional counseling, and holistic treatment modalities like aromatherapy. Energy work such as reiki healing is also not covered by First Health.

Online Therapy Coverage

First Health recognizes the importance of accessibility and safety in mental health services. As a result, they cover online therapy, allowing you to consult with your therapist from the comfort of your own home. Your First Health coverage remains the same, whether you choose to see your therapist in person or online. Before beginning online therapy, it’s advisable to check with your First Health plan to confirm that teletherapy is covered.

Couples Therapy Coverage

Unfortunately, First Health does not cover couples therapy. This is primarily due to the difficulty in providing the necessary diagnosis for mental health conditions that many insurance companies require for reimbursement. However, if you’re interested in couples therapy and are on a budget, there are alternative ways to access couples therapy.

No Referral Needed for Therapy

First Health primarily offers PPO plans, eliminating the need for a referral from your primary care doctor before seeking a therapist. This saves you time and money, allowing you to embark on your mental health journey as soon as you’re ready!

Seeking therapy and taking care of your mental well-being is essential. With First Health’s coverage for therapy services, you can find the support you need within their extensive network of qualified therapists. Remember to review your specific plan details to understand your mental health benefits fully.

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