Insurance Coverage with Pleiades

Which insurance plans does Pleiades accept?

Pleiades partners with therapists who accept a wide range of insurance plans. Our network currently includes providers who accept:

• Aetna
• Blue Cross Blue Shield (varies by state)
• Cigna
• UnitedHealthcare
• Optum
• Medicare
• Medicaid (varies by state)
• Tricare
• And many regional plans

Insurance acceptance varies by therapist. When using our matching system, you can indicate which insurance you have, and our algorithm will prioritize therapists in-network with your plan.

How do I verify my insurance benefits?

There are several ways to verify your insurance coverage for therapy through Pleiades:

1. Use our insurance verification tool - Enter your insurance information in your Pleiades profile, and we can help verify your benefits before your first session.
2. Contact your insurance company directly - Call the member services number on the back of your insurance card and ask about your mental health benefits, specifically for outpatient therapy or telehealth therapy.
3. Ask our support team for help - Our support specialists can guide you through the process of understanding your coverage.

When checking your benefits, be sure to ask about:

• Copays or coinsurance amounts for mental health services
• Whether you have a deductible that must be met first
• The number of covered sessions per year
• If there are any requirements for pre-authorization
• If telehealth therapy is covered

What if my therapist doesn't accept my insurance?

If you match with a therapist who doesn't accept your insurance plan, you have several options:

• Use out-of-network benefits - Many insurance plans offer partial reimbursement for out-of-network providers. We can provide you with superbills (detailed receipts) that you can submit to your insurance for potential reimbursement.
• Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA) - Therapy expenses are typically eligible for payment using HSA or FSA funds.
• Sliding scale options - Some therapists offer reduced rates based on financial need.
• Request a different match - You can request to be matched with a therapist who accepts your insurance plan.

What information do I need to provide for insurance billing?

To use insurance benefits, you'll typically need to provide:

• Your full name as it appears on your insurance card
• Your date of birth
• Insurance company name
• Member ID number
• Group number (if applicable)
• Insurance phone number (usually on back of card)
• Information about the policyholder (if not yourself)

Our secure platform allows you to store this information, making the billing process seamless.

How does Pleiades handle insurance claims?

Our process makes insurance billing straightforward:

1. When matched with an in-network therapist, your insurance information is securely shared with them
2. Your therapist submits claims directly to your insurance company
3. You pay only your responsibility portion (copay/coinsurance)
4. For out-of-network providers, you pay the full fee, and we provide superbills for submission to your insurance

Our systems are HIPAA-compliant, ensuring your health information remains secure throughout this process.

What mental health services are typically covered by insurance?

Most insurance plans cover the following mental health services:

• Individual therapy sessions - Typically covered for diagnosable mental health conditions
• Psychiatric evaluations - Initial consultations with psychiatrists
• Medication management - Follow-up appointments for psychiatric medication

Services that may have limited or no coverage:

• Couples or family therapy - Coverage varies widely by plan
• Psychological testing - May require pre-authorization
• Life coaching or career counseling - Typically not covered

What if my insurance denies a claim?

If your insurance company denies a claim for therapy services, we can help:

1. Verification - We'll check that all information was submitted correctly
2. Explanation - We'll help you understand why the claim was denied
3. Appeals assistance - We can guide you or your therapist through the appeals process
4. Alternative payment arrangements - We can discuss other payment options while the appeal is being processed

Common reasons for claim denials include pre-authorization requirements not being met, services deemed not medically necessary, or administrative errors in the claim submission.