Insurance
Therapy that takes Anthem Blue Cross and Blue Shield in Wisconsin
Specifically the Wisconsin plan, which is its own company rather than a branch of a national one.
Wisconsin is its own plan
Blue Cross Blue Shield is not one company. It is a group of independent regional companies that share a name and a symbol, and the Wisconsin one sets its own networks and its own contracts. A therapist listed as in network by a Blue plan in another state is not automatically in network for you here.
I am contracted with the Wisconsin plan, which is the one that matters if your coverage came from a Wisconsin employer.
Note
Your mental health benefit may not be run by the name on your card
Behavioral health for most of these commercial plans is administered by Carelon Behavioral Health, a company under the same parent. Your medical card says one thing; the company that authorises and pays for therapy is a different one, usually with its own phone number on the back of the card.
This trips people up constantly. If you call the main member services line and are told they cannot see a mental health benefit, you have not been refused. You have been given the wrong department.
If your Blue card came from another state
People move to Wisconsin carrying a Blue plan from wherever they used to live, and the plans participate in a shared arrangement that often lets you see providers outside your home plan area. If your card has a small suitcase symbol on it, that arrangement applies to you.
Two things follow. Your home plan, not the Wisconsin one, decides what you pay, so that is who to call. And you still need to be physically in Wisconsin during sessions, because that is about my licence rather than about your coverage.
What I’d ask them
- Who administers my behavioral health benefit, and what is their number?
- What is my cost for outpatient psychotherapy with a Licensed Professional Counselor?
- Has my deductible been met, and does it apply to mental health?
- Is telehealth covered at the same rate as in-person?
Before you call me
How to check your own benefit
I can tell you I am in network. Only your plan can tell you what that means for your wallet, because the answer is set by your specific coverage rather than by the insurer as a whole.
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Look at the back of your card
The member services number is there. If there is a separate behavioral health or mental health line, use that one instead.
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Ask about your benefit
Ask which company administers your behavioral health benefit. For a great many of these plans the answer is Carelon rather than the name on the front of your card.
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Write down what they tell you
Ask for a reference number for the call.
I’m licensed in Wisconsin only, so you need to be physically located in Wisconsin at the time of your session, whatever plan you carry.
Would rather not use insurance? Sessions are $125, and I keep a limited number of reduced-fee spots. More about fees
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