A Student Guide to Navigating Health Insurance and Finding
Health Care Providers
TABLE OF CONTENTS
I. TERMS AND DEFINTIONS – Unpacking the world of health insurance and medical terminology.
II. THE ANATOMY OF YOUR HEALTH INSURANCE CARD
III. IF YOU’RE A CURRENT STUDENT ON COLLEGE HEALTH INSURANCE
IV. IF YOU’RE A CURRENT STUDENT ON YOUR PARENT’S HEALTH INSURANCE
V. IF YOU’RE A GRADUATING STUDENT REMAINING ON PARENT’S HEALTH INSURANCE UNTIL AGE 26
VI. IF YOU’RE A GRADUATING STUDENT AND WILL BE RECEIVING HEALTH INSURANCE BENEFITS THROUGH AN EMPLOYER
VII. IF YOU WERE USING THE COLLEGE HEALTH INSURANCE AS A STUDENT, AND WILL NOT BE COVERED BY EITHER YOUR PARENT’S OR AN EMPLOYER’S HEALTH INSURANCE AFTER GRADUATION
I. TERMS AND DEFINITIONS
Unpacking the world of health insurance and medical terminology
Behavioral Health- Umbrella term used by insurance company to describe any sort of mental health treatment including counseling
Benefit- the 12-month period for which health insurance benefits are calculated, not always coinciding with the calendar year
Claim- A request by a plan member or provider for the insurance company to pay for medical services
Coinsurance- The amount you pay to share the cost of covered services after your deductible has been paid, usually a percentage rate
Copay- Fixed amount you are expected to pay at each appointment
Deductible- Amount of money you must pay each year to cover eligible medical expenses before insurance policy starts paying. Not all plans have a deductible.
Dependent- Any individual covered by another's insurance
Exclusion or limitation- any specific situation, condition, or treatment a plan does not cover
Explanation of benefits- Company's written explanation of how a medical claim was paid
HMO- A type of insurance plan that covers you only if you see a provider with that HMO’s network. In most cases, you need a primary care physician who can provide a referral for mental health services. HMOs tend to be more affordable, but you’ll get less coverage and more restrictions.
In-network provider- A health care professional that is part of your health plan's network, you generally pay less for services in network
Insured- The individual (you) whose health is covered by the insurance plan or policy
Insurer- The company responsible for paying claims (your insurance plan or policy)
Network- Group of doctors, hospitals, and other providers that work with your insurance company
Medicaid- The general name for health insurance that is subsidized (paid for) by the government for individuals under the age of 65 who do not have access to insurance otherwise. The names and policies will vary from state to state. Coverage is determined by income for those who qualify. (See section on Medicaid for more information). The Massachusetts branch of Medicaid is called MassHealth.
Out-of-network provider- Health care provider who does not work with your insurance company, these services could potentially cost more
Out-of-pocket maximum- The most money you will pay during a year of coverage, this includes deductibles, copayment, and coinsurance
PPO- A PPO is a type of insurance plan. PPOs will typically have a higher monthly premium but more flexibility to use providers both in and out of network without a referral compared to an HMO plan. Out-of-pocket medical costs can also run higher with a PPO plan.
Pre-existing Condition- A health problem that has been diagnosed before you had your insurance plan
Premium- What you pay, usually monthly, for your insurance plan. This is a bill and is unrelated to other expenses for care, medication, and treatment that you are expected to pay.
Prior authorization- A requirement that your doctor get approval from your insurance plan to prescribe a specific medication
Provider- The facility (clinic, hospital, etc.) or the licensed professional (doctor, psychologist, social worker, etc.) employed by the facility, who provides health care or mental health services.
Referral- A requirement that a healthcare provider get approval from your insurance plan for you to see a specialist
Sliding Scale- A pricing option for medical services that allows individuals to have reduced or free services based on their income
1095- If you receive insurance apart from your parents, this is a form you will receive in the mail from your insurance company. Keep this for your taxes!
*Definitions Provided by University of Washington and Burns Recreation Center
II. THE ANATOMY OF A HEALTH INSURANCE CARD
How to talk to your health insurance company
When seeking information about your insurance coverage, you can do so over the phone or online. To contact your insurance provider over the phone, call the customer service number on the back of your insurance card to speak with a representative. Be prepared to provide the representative with your insurance ID number (located on the front of your card), your date of birth, your home address, and your social security number. If you are on your parents’ insurance plan, you’ll also want the name of the parent who is the primary subscriber (the parent who officially provides the insurance).
When you first call, you will likely encounter an automated menu that asks you to select from a list of options. If one of those options sounds like it describes what you are looking for, you can select the number provided. If not, don’t be afraid to wait until you are given the option to
speak with a representative. If you are unsure, speak to a representative and they will make sure you get connected with someone who can answer your questions.
Reasons you might need to call your insurance provider
Assistance in finding a provider who takes your insurance plan
Information about what mental health (often referred to as behavioral health) services or other services your plan covers
Asking about what kind of a referral or authorization may be needed to see a provider
Asking about what kinds of prescriptions your plan will cover
Asking about in network benefits vs. out of network benefits
Tip: If you’re calling your insurance company to find out more about your coverage so you can see a therapist who takes your insurance, use the phrase “outpatient behavioral health” to describe what you are looking for. You can ask about your plan’s “outpatient behavioral health” coverage to find out how many sessions your plan covers and what kinds of copays you may be responsible for paying.
III. IF YOU’RE A CURRENT STUDENT ON COLLEGE HEALTH INSURANCE
For help understanding insurance terms, refer to the section “Terms and Definitions”.
What to know
If you are on the college insurance, this means you have not filled out the waiver and provided proof of another insurance plan, and you are automatically enrolled in the student Blue Cross Blue Shield insurance plan. Your year of coverage lasts until the end of July, when students will be given the waiver for the upcoming school year. If you do not fill out the waiver for next year, your coverage will automatically continue. If you’re a graduating student in May on this plan your coverage will expire July 31. For December graduates, your coverage will end December 31.
To view information about your student insurance plan, go to: https://www.gordon.edu/healthcenter/newstudents#insurance. From there you can scroll until you see a link directing you to universityhealthplans.com which will bring you to a page detailing your student health insurance.
To see what your student plan covers, you can select the “Summary of Benefits” tab under the “benefit information” option. On this page you can see what accessing different services may cost you. For example, seeing an outpatient therapist (seeing a therapist while you are not a patient in a hospital) who accepts Blue Cross Blue Shield will cost a $40 copay per visit or session.
How to use your plan
You can use your Blue Cross Blue Shield student insurance plan to access any of the services listed in your Summary of Benefits. Common uses of insurance include covering the cost of an Urgent Care or CVS Minute Clinic visit, being seen by a provider in the Health Center here at Gordon, visiting the Emergency Room, or seeing a mental health provider (therapist/counselor) off-campus.
Finding a general provider (doctor, therapist, psychiatrist, etc)
If you are trying to find a provider who takes your Blue Cross Blue Shield insurance and you are having trouble, most insurance companies offer a way to do this online. The first step is to go to your insurance company’s website. If you have never made an account on your insurance company’s website before, you may need to create an account.
To do so, make sure you have your insurance card nearby so you can enter important information such as your member ID number. If you are unsure of where to find important information on your insurance card, refer to the diagram of the insurance card to locate and interpret the information on your card. After you have created your account, look for a search bar or tab option to find a doctor, hospital, or provider. Click on this option.
You may have the option to search for a doctor or provider by name, specialty, zip code, or the name of the practice. This is a helpful tool because you can check if doctors, therapists, or specialists you are interested in take your insurance plan, or you can select the area of care you are seeking, and you will be given a list of providers. You will likely be able to narrow your search by selecting the number of miles you would be willing to drive to be seen by someone or by another filter.
At this point, you can begin to select providers that seem like they could be a potential fit. If the provider or the clinic has a website, check out the website and see if it seems like this provider might be what you’re looking for. If you are looking for a therapist, there are important factors to consider whether the therapist is the right fit for you.
Finding a therapist off-campus
If you are looking for off-campus mental health support, you can use the process described above to find an off-campus therapist who accepts your student Blue Cross Blue Shield insurance. Fortunately, BCBS is a very commonly accepted insurance plan in Massachusetts. While searching through the BCBS website may be a good strategy to find some potential therapist options, you can also check out our list of off campus providers to see a list of therapists and counseling practices that often work with Gordon students and/or Gordon alum. This can be found on our Counseling Center webpage at the following link: www.gordon.edu/counselingwellness
You will need to contact the potential therapists directly regarding insurance compatibility, current openings, etc. This list is not exhaustive, nor are any of these practitioners officially endorsed, but are resources in the local area that students have had success with.
You can also try searching the Private Practice Colloquium database for local practitioners in the Greater Boston area. Members are from all licensed mental health disciplines including psychologists, clinical social workers, mental health counselors, marriage and family therapists, clinical nurse specialists and psychiatrists.
Another way of searching for a therapist is by utilizing the database on Psychology Today. This allows you to search specifically by insurance, geographical area, clinical specialty, level of licensing/degree, clinician gender, faith, and more.
You can also try asking people in your life if they know of any therapists that may be a good fit for you. Often your Primary Care Provider (PCP, your doctor) might be able to point you in the right direction and can even help support you if you are looking for medication related to your mental health.
Assessing whether a therapist is a good fit
Once you have identified several potential therapists, you can take steps to see if the therapist feels like the right fit for you. Take advantage of the complimentary phone consultation many therapists offer to assess the situation. The following information may be helpful in determining whether this therapist is right for you:
• Ask if they are taking new patients/clients
• Confirm that they do take your insurance plan. The amount of the copay (what is due out of pocket at each visit) can be found on your insurance card.,
• Find out if they are offering sessions via telehealth or in person. If they are offering in person only, consider whether the location of their office is convenient for you. If they are offering telehealth only, consider whether you have a space where you would feel comfortable verbalizing your personal information. It will be important to let your provider know what state you are in as there are licensing restrictions between states.
• Give them some idea of what you need (ex: anxiety help, trauma work, etc.). Ask whether the therapist has had experience dealing with your concerns and how they might go about supporting your needs.
• Find out what kind of therapy they would likely provide (for example, long term versus short term, individual or group therapy, types of therapy offered) and see if that fits your expectations.
• When you call, take note of how you are treated.
• How long does it take to reach someone at their office?
• Do you get a call back if you have to leave a message? Are your questions answered? Do you feel like you are being heard?
• The right therapist for you should make you feel comfortable being open, honest, and vulnerable. If you feel good about the phone call, schedule to meet your potential therapist in person. This is the best way to determine whether it’s going to be a good fit moving forward.
• After the session, check in with yourself. Remember that you are NOT obligated to return just because the therapist offers you another appointment. If the therapist does not feel like a good fit for you, don’t go back. If you scheduled an appointment, but decide not to return, simply contact the therapist through whatever means and cancel. Be sure to confirm that they received this cancellation, so you don’t get charged.
IV. IF YOU’RE A CURRENT STUDENT ON YOUR PARENT’S HEALTH INSURANCE
For help understanding insurance terms, refer to the section “Terms and Definitions”.
What to know
If you are on a parent’s health insurance, you can use your insurance plan to access medical care through the Health Center. Depending on what type of plan you have and how locally you live, you may need to get a referral from your insurance company or primary care doctor before you visit the Health Center on-campus You will need to provide your health insurance card and subscriber information to the Health Center, just as you would any other medical practice.
Finding a general provider (doctor, therapist, psychiatrist, etc.)
If you are trying to find a provider who takes your insurance and you are having trouble, most insurance companies offer a way to do this online. The first step is to go to your insurance company’s website. If you have never made an account on your insurance company’s website before, you may need to create an account.
To do so, make sure you have your insurance card nearby so you can enter important information such as your member ID number. If you are unsure of where to find important
information on your insurance card, refer to the diagram of the insurance card to locate and interpret the information on your card. After you have created your account, look for a search bar or tab option to find a doctor, hospital, or provider. Click on this option.
You may have the option to search for a doctor or provider by name, specialty, zip code, or the name of the practice. This is a helpful tool because you can check if doctors, therapists, or specialists you are interested in take your insurance plan, or you can select the area of care you are seeking, and you will be given a list of providers. You will likely be able to narrow your search by selecting the number of miles you would be willing to drive to be seen by someone or by another filter.
At this point, you can begin to select providers that seem like they could be a potential fit. If the provider or the clinic has a website, check out the website and see if it seems like this provider might be what you’re looking for. If you are looking for a therapist, there are important factors to consider whether the therapist is the right fit for you.
Finding a therapist
If you would like to find a therapist off-campus, you will likely need to find a therapist who takes your insurance or check if your insurance plan offers reimbursement for seeing an out-ofnetwork provider (someone who doesn’t take your insurance). This will depend on what kind of insurance plan you have. If you are wanting to see a therapist who you know doesn’t take your insurance, you may want to call and ask, “does my plan offer reimbursement for seeing an outof-network provider?” If you’re trying to find a therapist who takes your insurance, your insurance company’s website may be a good strategy to find some potential therapist options.
You can also check out our list of off-campus providers to see a list of therapists and counseling practices that often work with Gordon students and/or Gordon alum. This can be found on our Center for Student Counseling & Wellness website: www.gordon.edu/counselingwellness
You will need to contact the potential therapists directly regarding insurance compatibility, current openings, etc. This list is not exhaustive, nor are any of these practitioners officially endorsed, but are resources in the local area that students have had success with.
You can also try searching the Private Practice Colloquium database for local practitioners in the Greater Boston area. Members are from all licensed mental health disciplines including psychologists, clinical social workers, mental health counselors, marriage and family therapists, clinical nurse specialists and psychiatrists.
Another way of searching for a therapist is by utilizing the database on Psychology Today. This allows you to search specifically by insurance, geographical area, clinical specialty, level of licensing/degree, clinician gender, faith, and more.
You can also try asking people in your life if they know of any therapists that may be a good fit for you. Often your Primary Care Provider (PCP, your doctor) might be able to point you in the right direction and can even help support you if you are looking for medication related to your mental health.
Assessing whether a therapist is a good fit
Once you have identified several potential therapists, you can take steps to see if the therapist feels like the right fit for you. Take advantage of the complimentary phone consultation many therapists offer to assess the situation. The following information may be helpful in determining whether this therapist is right for you:
• Ask if they are taking new patients/clients
• Confirm that they do take your insurance plan. The amount of the copay (what is due out of pocket at each visit) can be found on your insurance card.,
• Find out if they are offering sessions via telehealth or in person. If they are offering in person only, consider whether the location of their office is convenient for you. If they are offering telehealth only, consider whether you have a space where you would feel comfortable verbalizing your personal information. It will be important to let your provider know what state you are in as there are licensing restrictions between states.
• Give them some idea of what you need (ex: anxiety help, trauma work, etc.). Ask whether the therapist has had experience dealing with your concerns and how they might go about supporting your needs.
• Find out what kind of therapy they would likely provide (for example, long term versus short term, individual or group therapy, types of therapy offered) and see if that fits your expectations.
• When you call, take note of how you are treated.
• How long does it take to reach someone at their office?
• Do you get a call back if you have to leave a message? Are your questions answered? Do you feel like you are being heard?
• The right therapist for you should make you feel comfortable being open, honest, and vulnerable. If you feel good about the phone call, schedule to meet your potential therapist in person. This is the best way to determine whether it’s going to be a good fit moving forward.
• After the session, check in with yourself. Remember that you are NOT obligated to return just because the therapist offers you another appointment. If the therapist does not feel like a good fit for you, don’t go back. If you scheduled an appointment, but decide not to return, simply contact the therapist through whatever means and cancel. Be sure to confirm that they received this cancellation, so you don’t get charged.
V. IF YOU’RE A GRADUATING STUDENT REMAINING ON YOUR PARENT’S HEALTH INSURANCE UNTIL AGE 26
For help understanding insurance terms, refer to the section “Terms and Definitions”.
What to know
If you are a graduating student remaining on your parent’s insurance plan, you can use your insurance plan to access providers. If you are not moving back to the area where you were living before college, you will likely need to find providers such as doctors, dentists, and/or therapists who accept your parent’s insurance plan.
Finding a general provider (doctor, therapist, psychiatrist, etc)
If you are trying to find a provider who takes your insurance and you are having trouble, most insurance companies offer a way to do this online. The first step is to go to your insurance company’s website. If you have never made an account on your insurance company’s website before, you may need to create an account.
To do so, make sure you have your insurance card nearby so you can enter important information such as your member ID number. If you are unsure of where to find important information on your insurance card, refer to the diagram of the insurance card to locate and interpret the information on your card. After you have created your account, look for a search bar or tab option to find a doctor, hospital, or provider. Click on this option.
You may have the option to search for a doctor or provider by name, specialty, zip code, or the name of the practice. This is a helpful tool because you can check if doctors, therapists, or specialists you are interested in take your insurance plan, or you can select the area of care you are seeking, and you will be given a list of providers. You will likely be able to narrow your search by selecting the number of miles you would be willing to drive to be seen by someone or by another filter.
At this point, you can begin to select providers that seem like they could be a potential fit. If the provider or the clinic has a website, check out the website and see if it seems like this provider might be what you’re looking for. If you are looking for a therapist, there are important factors to consider whether the therapist is the right fit for you.
Finding a therapist
If you are graduating and thinking that you may want to find a therapist, you will likely need to find a therapist who takes your insurance or check if your insurance plan offers reimbursement for seeing an out-of-network provider (someone who doesn’t take your insurance). This will depend on what kind of insurance plan you have. If you are wanting to see a therapist who you know doesn’t take your insurance, you may want to call and ask, “does my plan offer reimbursement for seeing an out-of-network provider?” If you’re trying to find a therapist who takes your insurance, your insurance company’s website may be a good strategy to find some potential therapist options.
If you are staying on the North Shore after graduation, you can also check out our list of off campus providers to see a list of therapists and counseling practices that often work with Gordon students and/or Gordon alum.
This can be found on our Counseling Center webpage at the following link: www.gordon.edu/counselingwellness
You will need to contact the potential therapists directly regarding insurance compatibility, current openings, etc. This list is not exhaustive, nor are any of these practitioners officially endorsed, but are resources in the local area that students have had success with.
You can also try searching the Private Practice Colloquium database for local practitioners in the Greater Boston area. Members are from all licensed mental health disciplines including psychologists, clinical social workers, mental health counselors, marriage and family therapists, clinical nurse specialists and psychiatrists.
Another way of searching for a therapist, especially if you are not staying on the North Shore, is by utilizing the database on Psychology Today. This allows you to search specifically by insurance, geographical area, clinical specialty, level of licensing/degree, clinician gender, faith, and more.
You can also try asking people in your life if they know of any therapists that may be a good fit for you. Often your Primary Care Provider (PCP, your doctor) might be able to point you in the right direction and can even help support you if you are looking for medication related to your mental health.
Assessing whether a therapist is a good fit
Once you have identified several potential therapists, you can take steps to see if the therapist feels like the right fit for you. Take advantage of the complimentary phone consultation many therapists offer to assess the situation. The following information may be helpful in determining whether this therapist is right for you:
• Ask if they are taking new patients/clients
• Confirm that they do take your insurance plan. The amount of the copay (what is due out of pocket at each visit) can be found on your insurance card.,
• Find out if they are offering sessions via telehealth or in person. If they are offering in person only, consider whether the location of their office is convenient for you. If they are offering telehealth only, consider whether you have a space where you would feel comfortable verbalizing your personal information. It will be important to let your provider know what state you are in as there are licensing restrictions between states.
• Give them some idea of what you need (ex: anxiety help, trauma work, etc.). Ask whether the therapist has had experience dealing with your concerns and how they might go about supporting your needs.
• Find out what kind of therapy they would likely provide (for example, long term versus short term, individual or group therapy, types of therapy offered) and see if that fits your expectations.
• When you call, take note of how you are treated.
• How long does it take to reach someone at their office?
• Do you get a call back if you have to leave a message? Are your questions answered? Do you feel like you are being heard?
• The right therapist for you should make you feel comfortable being open, honest, and vulnerable. If you feel good about the phone call, schedule to meet your potential therapist in person. This is the best way to determine whether it’s going to be a good fit moving forward.
• After the session, check in with yourself. Remember that you are NOT obligated to return just because the therapist offers you another appointment. If the therapist does not feel like a good fit for you, don’t go back. If you scheduled an appointment, but decide not to return, simply contact the therapist through whatever means and cancel. Be sure to confirm that they received this cancellation, so you don’t get charged.
VI. IF YOU’RE A GRADUATING STUDENT AND WILL BE RECEIVING HEALTH INSURANCE BENEFITS THROUGH AN EMPLOYER
For help understanding insurance terms, refer to the section “Terms and Definitions”.
What to know
Most employers are only able to provide health insurance for full-time employees and will usually offer this as part of your compensation package (salary, benefits, etc). You will usually be required to pay a monthly amount (your premium) to opt into that health insurance plan, in addition to whatever copay or deductible amounts that the plan offers. You may be offered the
option to choose between a high-deductible plan with a lower premium or a higher premium with no deductible.
Basically, this means you may have the option to choose between a plan with a low monthly cost, but you will need to pay more for health services before insurance starts to cover you, and a plan with a higher monthly cost but being able to use insurance to cover the cost of health services much sooner, if not right away. It may be helpful to consider how often you typically need to access health care services in making the choice. It is also possible that your place of employment may only offer one type of insurance plan
Once you have gone through the process of enrolling in your new insurance plan as directed by your place of work, you can use your insurance to access health care services. If you were previously seeing a primary care doctor or therapist, you can call the office to let them know you have changed insurance plans and to check if they take your new plan. If they do not, you may need to find new providers who do take your new insurance.
How to use your plan
Your new insurance plan will likely send you a packet outlining your benefits through your new plan. You can look through this packet or on your insurance company’s website to see your summary of benefits. Be sure to pay attention to your co-pay (the amount you are responsible for paying at the time of the appointment) for various services. You may see the phrase “behavioral health” listed in your benefits. This refers to the coverage your insurance plan offers for seeing a therapist who takes insurance. You may also want to take note of what you would be responsible for paying to see a doctor, visit urgent care, or the Emergency Room, as these are common uses of insurance.
Finding a general provider (doctor, therapist, psychiatrist, etc)
If you are trying to find a provider who takes your insurance and you are having trouble, most insurance companies offer a way to do this online. The first step is to go to your insurance company’s website. If you have never made an account on your insurance company’s website before, you may need to create an account.
To do so, make sure you have your insurance card nearby so you can enter important information such as your member ID number. If you are unsure of where to find important information on your insurance card, refer to the diagram of the insurance card to locate and interpret the information on your card. After you have created your account, look for a search bar or tab option to find a doctor, hospital, or provider. Click on this option.
You may have the option to search for a doctor or provider by name, specialty, zip code, or the name of the practice. This is a helpful tool because you can check if doctors, therapists, or
specialists you are interested in take your insurance plan, or you can select the area of care you are seeking, and you will be given a list of providers. You will likely be able to narrow your search by selecting the number of miles you would be willing to drive to be seen by someone or by another filter.
At this point, you can begin to select providers that seem like they could be a potential fit. If the provider or the clinic has a website, check out the website and see if it seems like this provider might be what you’re looking for. If you are looking for a therapist, there are important factors to consider whether the therapist is the right fit for you.
Finding a therapist
If you are graduating and thinking that you may want to find a therapist, you will likely need to find a therapist who takes your insurance or check if your insurance plan offers reimbursement for seeing an out-of-network provider (someone who doesn’t take your insurance). This will depend on what kind of insurance plan you have. If you are wanting to see a therapist who you know doesn’t take your insurance, you may want to call and ask, “does my plan offer reimbursement for seeing an out-of-network provider?” If you’re trying to find a therapist who takes your insurance, your insurance company’s website may be a good strategy to find some potential therapist options.
If you are staying on the North Shore after graduation, you can also check out our list of off campus providers to see a list of therapists and counseling practices that often work with Gordon students and/or Gordon alum.
This can be found on our Counseling Center webpage at the following link: www.gordon.edu/counselingwellness
You will need to contact the potential therapists directly regarding insurance compatibility, current openings, etc. This list is not exhaustive, nor are any of these practitioners officially endorsed, but are resources in the local area that students have had success with.
You can also try searching the Private Practice Colloquium database for local practitioners in the Greater Boston area. Members are from all licensed mental health disciplines including psychologists, clinical social workers, mental health counselors, marriage and family therapists, clinical nurse specialists and psychiatrists.
Another way of searching for a therapist, especially if you are not staying on the North Shore, is by utilizing the database on Psychology Today. This allows you to search specifically by insurance, geographical area, clinical specialty, level of licensing/degree, clinician gender, faith, and more.
You can also try asking people in your life if they know of any therapists that may be a good fit for you. Often your Primary Care Provider (PCP, your doctor) might be able to point you in the right direction and can even help support you if you are looking for medication related to your mental health.
Assessing whether a therapist is a good fit
Once you have identified several potential therapists, you can take steps to see if the therapist feels like the right fit for you. Take advantage of the complimentary phone consultation many therapists offer to assess the situation. The following information may be helpful in determining whether this therapist is right for you:
• Ask if they are taking new patients/clients
• Confirm that they do take your insurance plan. The amount of the copay (what is due out of pocket at each visit) can be found on your insurance card.,
• Find out if they are offering sessions via telehealth or in person. If they are offering in person only, consider whether the location of their office is convenient for you. If they are offering telehealth only, consider whether you have a space where you would feel comfortable verbalizing your personal information. It will be important to let your provider know what state you are in as there are licensing restrictions between states.
• Give them some idea of what you need (ex: anxiety help, trauma work, etc.). Ask whether the therapist has had experience dealing with your concerns and how they might go about supporting your needs.
• Find out what kind of therapy they would likely provide (for example, long term versus short term, individual or group therapy, types of therapy offered) and see if that fits your expectations.
• When you call, take note of how you are treated.
• How long does it take to reach someone at their office?
• Do you get a call back if you have to leave a message? Are your questions answered? Do you feel like you are being heard?
• The right therapist for you should make you feel comfortable being open, honest, and vulnerable. If you feel good about the phone call, schedule to meet your potential therapist in person. This is the best way to determine whether it’s going to be a good fit moving forward.
• After the session, check in with yourself. Remember that you are NOT obligated to return just because the therapist offers you another appointment. If the therapist does not feel like a good fit for you, don’t go back. If you scheduled an appointment, but decide not to return, simply contact the therapist through whatever means and cancel. Be sure to confirm that they received this cancellation, so you don’t get charged.
VII. IF YOU WERE USING THE COLLEGE HEALTH INSURANCE AS A STUDENT, AND WILL NOT BE COVERED BY EITHER YOUR PARENT’S OR AN EMPLOYER’S HEALTH INSURANCE AFTER GRADUATION
For help understanding insurance terms, refer to the section “Terms and Definitions”.
What to know
In most states, after the age of 26, you will become eligible for government subsidized health insurance (Medicaid) if you are not employed, or your employer does not provide health insurance benefits. If you are a graduating senior under age 26 who will be needing health insurance coverage, don’t panic! Many adults receive health insurance through their place of employment. However, we recognize that finding a job after college is stressful. Sometimes we don’t find full-time work with benefits right off the bat.
If you are worried that this will be your situation, you can still access health insurance through the state, whether you’re planning on staying in the Gordon area or moving to a different state. In Massachusetts, if you are a US citizen and live in and/or are employed in Massachusetts, you are considered a MA resident.
International Students
If you are an international student here on a visa, the laws around your access to government subsidized health care may be more complex depending on things like OPT In the months leading up to graduation, the International Student office will reach out to you and remind you that you are responsible for maintaining "adequate" health insurance coverage from an American health insurance company during the entire time they're in the U.S. as an F1 status person, whether during your time as a student or while on OPT after graduating. The definition of "adequate" is an official legal thing, and I have some links about that. To find out what options are available to you, continue reading to find out how you can go to your state’s website to navigate this.
Medicaid insurance eligibility
Medicaid is an umbrella term for all government subsidized health insurance, but each state may have their own name and health insurance products. For example, Medicaid in Massachusetts is called MassHealth
Your eligibility will be based on your individual income, and you may qualify for differing levels of coverage and at different price points. If you are under 26 and your parents/guardian claimed you as a dependent on their most recent tax forms, their income may also be a factor in determining your eligibility. You may want to have your income and/or your parent or guardian’s income information on hand before you begin the process of applying for Medicaid.
How to apply for MassHealth
If you are applying for MassHealth, you can do so on the MA Health Connector website. You will want to have your personal information ready, as well as your income information or your parents’ income information if they claim you as a dependent on their taxes.
After filling out an application, you will receive a letter detailing what level of care you qualify for. You will then need to log back onto the MA Health Connector website and enroll in one of the plans available to you. If you already have medical providers who you want to continue seeing, you may want to contact the provider's office before picking your plan and ask what versions, if any, of MassHealth they accept. This may help inform your decision of what plan to choose. It is important to note that if you do not go through the process of picking a plan after hearing about what level of care you qualify for, MassHealth will randomly select a plan for you, and it may not be a plan that your current providers accept.
If this process feels overwhelming, there are community resources available for you. If you are in the North Shore area, you can schedule an appointment with the insurance consultant at Beverly Hospital. This person will walk you through the application process and help you pick the MassHealth plan that is the best fit for you. You can email the Beverly consultant at this email address: susanc@nhs-healthlink.org
If you are in Massachusetts but not on the North Shore, you can search for MassHealth insurance consultants near you to see what kind of assistance your community offers in navigating this process.
How to apply for Medicaid in another state
If you are going to be living in a state other than Massachusetts but will still be needing health insurance, you can see what plans your state offers by visiting:
https://www.healthcare.gov/get-coverage/
You can select your state from the list and create an account on the website. From there, you will find out if your state uses healthcare.gov for their insurance, or if they have a separate page like Massachusetts does. If your state has a separate page, you will automatically be redirected to that page either at this time or directly after selecting your state from the list.
Your state’s form of Medicaid may go by a different name like MassHealth. For example, in Connecticut, Medicaid if called HuskyHealth. To see what Medicaid is called in your state, you visit this link:
https://www.medicaidplanningassistance.org/state-medicaid-resources/
After creating an account either on healthcare.gov or your state’s equivalent, you will need to fill out an application. Be sure to have your personal information ready along with any relevant income information. After submitting your application, you will likely hear back about the level
of care you qualify for within a few business days. At that time, you will be able to see what your options are for picking a plan.
How to use your plan
Your new insurance plan will likely send you a packet outlining your benefits through your new plan. You can look through this packet or on your insurance company’s website to see your summary of benefits. Be sure to pay attention to your copay (the amount you are responsible for paying at the time of the appointment) for various services. You may see the phrase “behavioral health” listed in your benefits. This refers to the coverage your insurance plan offers for seeing a therapist who takes insurance. You may also want to take note of what you would be responsible for paying to see a doctor, visit urgent care, or the Emergency Room, as these are common uses of insurance.
Finding a general provider (doctor, therapist, psychiatrist, etc)
If you are trying to find a provider who takes your Medicaid insurance and you are having trouble, most insurance companies offer a way to do this online. The first step is to go to your insurance company’s website. If you have never made an account on your insurance company’s website before, you may need to create an account.
To do so, make sure you have your insurance card nearby so you can enter important information such as your member ID number. If you are unsure of where to find important information on your insurance card, refer to the diagram of the insurance card to locate and interpret the information on your card. After you have created your account, look for a search bar or tab option to find a doctor, hospital, or provider. Click on this option.
You may have the option to search for a doctor or provider by name, specialty, zip code, or the name of the practice. This is a helpful tool because you can check if doctors, therapists, or specialists you are interested in take your insurance plan, or you can select the area of care you are seeking, and you will be given a list of providers. You will likely be able to narrow your search by selecting the number of miles you would be willing to drive to be seen by someone or by another filter.
At this point, you can begin to select providers that seem like they could be a potential fit. If the provider or the clinic has a website, check out the website and see if it seems like this provider might be what you’re looking for. If you are looking for a therapist, there are important factors to consider whether the therapist is the right fit for you.
Finding a therapist
If you are graduating and thinking that you may want to find a therapist, you will likely need to find a therapist who takes your insurance or check if your insurance plan offers reimbursement for seeing an out-of-network provider (someone who doesn’t take your insurance). This will depend on what kind of insurance plan you have. If you are wanting to see a therapist who you know does not take your insurance, you may want to call and ask, “does my plan offer reimbursement for seeing an out-of-network provider?” If you’re trying to find a therapist who takes your insurance, your insurance company’s website may be a good strategy to find some potential therapist options.
If you are staying on the North Shore after graduation, you can also check out our list of off campus providers to see a list of therapists and counseling practices that often work with Gordon students and/or Gordon alum. You will need to call the office and ask whether or not they accept any forms of MassHealth.
This can be found on our Counseling Center webpage at the following link: www.gordon.edu/counselingwellness
You will need to contact the potential therapists directly regarding insurance compatibility, current openings, etc. This list is not exhaustive, nor are any of these practitioners officially endorsed, but are resources in the local area that students have had success with.
You can also try searching the Private Practice Colloquium database for local practitioners in the Greater Boston area. Members are from all licensed mental health disciplines including psychologists, clinical social workers, mental health counselors, marriage and family therapists, clinical nurse specialists and psychiatrists.
Another way of searching for a therapist, especially if you are not staying on the North Shore, is by utilizing the database on Psychology Today. This allows you to search specifically by insurance, geographical area, clinical specialty, level of licensing/degree, clinician gender, faith, and more.
You can also try asking people in your life if they know of any therapists that may be a good fit for you. Often your Primary Care Provider (PCP, your doctor) might be able to point you in the right direction and can even help support you if you are looking for medication related to your mental health.
Assessing whether a therapist is a good fit
Once you have identified several potential therapists, you can take steps to see if the therapist feels like the right fit for you. Take advantage of the complimentary phone consultation many therapists offer to assess the situation. The following information may be helpful in determining whether this therapist is right for you:
• Ask if they are taking new patients/clients
• Confirm that they do take your insurance plan. The amount of the copay (what is due out of pocket at each visit) can be found on your insurance card.,
• Find out if they are offering sessions via telehealth or in person. If they are offering in person only, consider whether the location of their office is convenient for you. If they are offering telehealth only, consider whether you have a space where you would feel comfortable verbalizing your personal information. It will be important to let your provider know what state you are in as there are licensing restrictions between states.
• Give them some idea of what you need (ex: anxiety help, trauma work, etc.). Ask whether the therapist has had experience dealing with your concerns and how they might go about supporting your needs.
• Find out what kind of therapy they would likely provide (for example, long term versus short term, individual or group therapy, types of therapy offered) and see if that fits your expectations.
• When you call, take note of how you are treated.
• How long does it take to reach someone at their office?
• Do you get a call back if you have to leave a message? Are your questions answered? Do you feel like you are being heard?
• The right therapist for you should make you feel comfortable being open, honest, and vulnerable. If you feel good about the phone call, schedule to meet your potential therapist in person. This is the best way to determine whether it’s going to be a good fit moving forward.
• After the session, check in with yourself. Remember that you are NOT obligated to return just because the therapist offers you another appointment. If the therapist does not feel like a good fit for you, don’t go back. If you scheduled an appointment, but decide not to return, simply contact the therapist through whatever means and cancel. Be sure to confirm that they received this cancellation, so you don’t get charged.