Insurance tool
The call script.
Call the member services or behavioral health number on the back of your card. Read these out loud. Write down the answers.
- Is this facility in-network for my plan? I am looking at group number ___.
- What is my deductible, and how much of it have I met this year?
- What is my coinsurance for inpatient and for outpatient behavioral health?
- What is my out-of-pocket maximum, and how much have I met?
- Do detox, residential, PHP and IOP need prior authorization? Who has to request it?
- If I go out of network, what is the allowed amount per day for residential treatment?
- Is there a limit on days or visits per year?
- Can I have a reference number for this call, and your name?
Not sure where to start?
Tell us what is going on. Someone who has been there will point you to the next right step. No pressure, no sales pitch.