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[quote=Anonymous]Therapy for anxiety should always be covered. The question is do you have out of network benefits. If you only have in network and see someone out of network, you can’t be reimbursed. If you have out of network coverage, you can submit a superbill for partial reimbursement. What they reimburse depends on your plan deductible, coinsurance and what the rate is they consider reasonable. When my kids saw out of network providers under our old Cigna plan, we paid the first $750 in full and then they paid 70% of each visit. They considered the amount the therapists paid reasonable so reimbursed 70% of the full fee. Now we have a lousy plan through an Aetna subsidiary that has a $5000 deductible and then will only pay 50% of a discounted rate. So we have to cover the first $5000 in costs out of pocket and can then be reimbursed 50% of what they’d be willing to pay. I think when we hit the deductible we’ll get back something like $75 a visit which isn’t much but beats nothing. So it is very plan dependent.  For this reason, we cut one back to every other week and the other is now on a sliding scale. Ask the provider for options if you truly can’t afford it. As for OT and speech, my kids had both years ago. One was covered under what I think was called the Habilitative therapy act in MD. The other 2 were initially rejected for speech but eventually we were able to get them covered. We filed an appeal and we also then had to ask the SLP to send periodic progress reports to justify continuing. It’s a pain but well worth it. Don’t give up on it. As for OT, our plan when they were young always covered it. Some OTs know which codes are most likely to be reimbursed so that can be helpful. For example, my kids all had hypotonia and one had a muscle weakness, so she used those diagnoses rather than something like dysgraphia.

Finally, you can keep good records and take all of it off (minus tutoring) as medical expenses. [/quote]

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