We participate in PPO insurance plans, including Blue Cross Blue Shield, UnitedHealthcare, as well as Medicare. We may also accept additional insurance plans. Please feel free to inquire if we accept your insurance plan. We currently do not accept HMO or Medicaid insurance plans.
Insured clients are responsible for the client portion of SamaraCare’s fees as indicated by their insurance company benefit plan and explanation of benefits (EOB).
Clients with a deductible are responsible for the client portion of the SamaraCare fee. Clients will be notified of their approximate per-session responsibility. Until the actual per-session liability is established, SamaraCare’s full fee will be on the client’s account. When an EOB is received, the client will be informed of their actual financial responsibility and their account will be adjusted accordingly.
NO OR LIMITED HEALTH INSURANCE
Uninsured or underinsured clients may apply for reduced fees through our Mental Health Access Program (MHAP). Those applying for financial assistance from the MHAP are required to provide documentation to establish eligibility for the reduced fee prior to their 2ND appointment. MHAP clients are required to renew eligibility annually or whenever there’s a significant change in their financial circumstances.
Verification of Insurance Coverage
SamaraCare will attempt to verify a client’s financial responsibility with their insurance provider. However, we cannot guarantee insurance coverage or payment by the insurance company. Therefore, any and all charges incurred are ultimately the client’s responsibility.
Change in Insurance Status:
If a client acquires, loses, or has a change in insurance coverage they are required to inform SamaraCare immediately.
It is ultimately the client’s responsibility to confirm if SamaraCare is in network with their insurance company. If a client chooses to use their out of network benefits for services at SamaraCare, or if SamaraCare is out of network for a client who has no out of network benefits, the client is responsible for our full fee.
Exhaustion of Mental Health Benefits
Clients who have exhausted their mental health benefits may still qualify for a reduced fee based on their income and household size. However, eligibility for a reduced fee will be discontinued at the time of the renewal of their insurance plan year.