I'm trying to figure out the best choice for individual health insurance for myself, and I'd like to have it pay for my currently-out-of-pocket therapy, but I have questions about how this works. Does therapy count as an "office visit"? Do I actually want insurance to cover therapy? (I'm in the US.)
I'm currently insured but on a plan that isn't helpful for me. I'm trying to decide between two PPO plan types from Anthem Blue Cross California
(assume the annual deductibles and maximum out-of-pocket costs are similar):
Plan A: Premium is $100. Office visits are $30 per visit, 3 visits per year (additional visits covered at 30% after annual deductible).
Plan B: Premium is $130. Office visits are $30 per visit for as many as you like.
(I looked at HMO and HSA options and I don't want them.)
My psychologist is $150/session, and I'm currently doing weekly sessions, paying out of pocket. The only type of insurance he takes is Blue Cross. I like him and we're making progress, so I don't want to switch. I can afford this, but it'd be great if insurance paid for it instead. I haven't been able to find any details about talk therapy coverage in the Blue Cross brochures or website.
Does therapy count as an "office visit"? If therapy counts as an "office visit", plan B is better. If therapy doesn't count as an "office visit", plan A is better. But would insurance even cover therapy since I don't have a formally diagnosed disorder, just general issues? And do I want insurance to cover therapy at all, if I can afford to pay for it out-of-pocket? I don't have any diagnosed pre-existing conditions right now, and I'd really like to keep that lucky status for as long as possible. If a couple thousand dollars of out-of-pocket spending right now prevents having serious insurance problems in the future, that seems worthwhile. But if I can safely use insurance to pay that couple thousand dollars, that would be nice.