Paramount Healthcare Insurance - In Person & Online Therapist
Toledo Family Therapy is now accepting Paramount Healthcare Insurance.
Call or email to schedule a free phone consultation. Call (419) 973-8009
Does Paramount Healthcare Insurance cover therapy?
Yes. Most Paramount Healthcare Insurance plans cover therapy.
Health insurance offered through the general market or through employers are required by the Affordable Care Act to cover mental health services.
While not required by federal law, most large employers also cover mental health services.
However, Paramount Healthcare plan may not cover therapy services if:
- You work for a large employer that does not include mental health benefits in its insurance coverage.
- Your health insurance plan was created before 2014, when the ACA’s requirement that health insurance plans cover mental health services was enacted. There are other situations in which your Paramount Healthcare plan may not cover the specific type of therapy service you are seeking, or where your coverage may not apply until you spend a certain amount on medical services first.
How can I find out if my Paramount Healthcare Insurance plan covers therapy?
You can find your Summary of Benefits by logging into your Paramount Healthcare Insurance Member Services portal, calling member services, or checking your employer’s benefits portal.
While your Paramount Healthcare likely covers therapy, the extent of coverage and requirements for coverage depend on your particular plan. Read on to learn more.
How much does therapy cost with a Paramount Healthcare plan?
If you choose a therapist who is in-network with Paramount Healthcare, your therapy sessions likely cost between $15 - $50 per session, after you meet your deductible. The $15 - $50 amount is your copay, or the fixed amount that you owe at each therapy visit. The deductible is the total amount you need to spend in medical costs in any given year before your health insurance begins to cover the cost of services.
What mental health conditions does Paramount Healthcare cover?
Mental health conditions Paramount Healthcare Health covers may include:
- Anxiety
- Depression
- Trauma
- Attention-deficit/hyperactivity disorder (ADHD)
- Obsessive Compulsive Disorder (OCD)
- Eating disorders
- Mood disorders, such as bipolar disorder
- Substance use disorder
Note that therapists are required to assign you a diagnosis for the above conditions, as well as share the diagnosis with your health insurer, if you are using insurance benefits to pay for therapy.
If you don’t want your insurance company (or family members, if you have a shared plan) to have access to this information about your mental health, consider out-of-network options instead.
What types of therapy does Paramount Healthcare not cover?
Paramount Healthcare plans cover most types of therapy, including individual therapy and child therapy, as well as different types of therapy approaches, including:
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Psychodynamic Therapy
- Acceptance and Commitment Therapy
Any therapy type that is evidence-based and utilized for the purposes of diagnosis and treatment of mental health conditions should be covered by Paramount Healthcare plans.
What kinds of therapy does Paramount Healthcare not cover?
Like most insurances, it is not typical for Paramount Healthcare to cover services unrelated to a diagnosable mental health condition, such as:
- Couples counseling - Couples counseling is typically not covered by insurance, because relationship issues, while a significant source of stress, are not considered a diagnosable mental health condition.
- Life coaching - Life coaching is not covered by insurance because it focuses on achieving personal goals, rather than treating a diagnosable mental health condition.
- Career coaching - Career coaching is not covered by insurance because it focuses on achieving professional goals, rather than treating a diagnosable mental health condition.
Paramount Healthcare is also unlikely to cover therapy sessions occurring outside the therapy office, because of the greater potential for risk involved. While clients may sometimes benefit from services rendered outside of the therapy office, such as a client with an eating disorder needing support in the grocery store, or a client with a phobia of driving needing support in the car, these services are not likely to be covered by insurance and must be paid for out-of-pocket.
Does Paramount Healthcare cover online therapy?
Yes, most Paramount Healthcare insurance plans cover online therapy.
You can go through those directories, or ask member services whether online sessions with your therapist of choice are covered.
Does Paramount Healthcare cover couples counseling?
No. While it depends on your specific plan, it is unlikely that Paramount Healthcare will cover couples counseling.
That said, even if your insurance doesn't directly cover it, you still have options for getting affordable couples counseling. Here are five ways to pay for couples counseling if it’s not included in your health insurance plan.
Do I need to see my doctor before visiting a Paramount therapist?
If you need to see your primary care doctor before visiting a Paramount Healthcare therapist depends on your insurance plan type:
- HMO or POS plan: Yes, you are typically required to see your primary care physician for a referral to therapy before Paramount Healthcare will pay for services
- PPO or EPO plan: No, you typically don’t need to see your primary care physician for a referral to therapy before Paramount Healthcare will pay for services.
This referral requirement is also called pre-authorization (or prior authorization). Pre-authorization is a process where a health provider, in this case your therapist, must get approval from your insurance company before providing you with care in order for the services to be covered. Your Summary of Benefits should indicate whether you need pre-authorization for outpatient mental health services.