If you have been searching for therapeutic boarding schools for your troubled teen you may have realized the sticker shock of the tuition fees. Most of the websites do not list their fees or costs — which is likely the first clue that it is more than most can afford. Many parents search for therapeutic programs that take insurance.
It is normal for a family to want to use their medical insurance to cover a therapeutic boarding school or residential treatment center, however first they must have a better understanding of how it works in the teenage mental health field.
Will A Therapeutic Boarding School Take My Insurance?
Yes and no is the short answer.
Depending on your insurance policy, is where you answer starts. Most PPO (Preferred Provider Organization) policies will offer out-of-network benefits after you have meet an out-of-network deductible. These providers include (but not limited to): Aetna, Cigna, United Healthcare and (UMR), and Blue Cross Blue Shield.
If you decide to stay in-network with your PPO provider, you will have more financial coverage. The one struggle parents run into is they are typically shorter-term facilities and the more concerning issue is the teenager has to be a willing participant. In other words, they don’t permit your teen to be transported to the program.
When considering private therapeutic boarding schools, PPO insurance out-of-network benefits will typically cover a portion of the clinical component of the program, however you will still have out-of-pocket costs. These schools and programs will offer you a courtesy verification of benefits (VOB) to give you a strong determination of what is covered for you. By having the program complete the VOB for you, rather than doing this yourself, you will get a more accurate result — since they have a better understanding of their billing codes.
There are some therapeutic boarding schools that will file your insurance for you and deduct it from your invoices, while other programs will give you what they call super-bills. With these super-bill invoices, you will have to file them with your provider and wait for your reimbursement.
HMO, Medicaid, Tricare Insurance
With HMO, Medicaid and most Tricare insurances, they require you to stay in-network to have financial coverage.
Tricare does have some exceptions with some of their policies providing a PPO-like coverage. Please review your policy.
When you have an insurance policy that requires you to stay in-network, you need to contact them directly and ask for residential treatment facilities in-network. In many situations, they may give you to their mental health department and assign you a case worker or have refer you to a therapist that can determine if a therapeutic facility is necessary.
There are exceptions to staying in-network — this is called a “Single Case Agreement.” If you have exhausted your resources in-network, you can ask them cover services outside of their network.
A Single Case Agreement (SCA) is a one-time contract between an insurance company and an out-of-network provider so the patient can see that provider using their in-network benefits.
There are many situations when a SCA has been successfully used.
Finding Therapeutic Boarding Schools That Take Insurance
If you are interested in private residential treatment centers or therapeutic boarding schools that will file your insurance, there are several in our country that offer this benefit. There are many that will give you super-bills for you to file your own for reimbursement. Contact us for more information.