Understanding Out-of-Network Insurance

If you do not see your health plan on this list of in-network health plans managed by one of Alma's network partners, or if the Alma team finds that your health plan is not in-network with our Insurance Program, then your provider will not be able to submit insurance claims for your sessions through Alma.

Instead, your provider will create invoices for you at their private rate. You should discuss these rates with your provider, so that you are both clear on expectations for payment. 

For additional context on ineligible plans; providers who are part of Alma’s Insurance Program are able to accept clients with commercial plans under our payer partners, Aetna, Cigna, Optum, and Empire BCBS. Community or state plans, such as NYSHIP, 1199SEIU, or any plans managed by Medicare or Medicaid, are not currently supported by Alma’s insurance partnerships. 

That said, being a private-pay client does not mean that you won't get any coverage for your Alma visits! Your health plan benefits may include out-of-network reimbursement for a portion of your session costs. You can reach out to the phone number on the back of your insurance card to ask:

  • whether you are eligible for any out-of-network coverage, and
  • what you will need to submit as documentation to apply for reimbursement.

Generally, your insurance company will require detailed invoices and superbills (i.e., monthly statements of all of the invoices you paid to a provider) to reimburse your expenses. You can submit this documentation directly to your health plan for processing. 

As you submit for reimbursement, if you have any questions related to your specific plan, please call the phone number listed on the back of your insurance card for further assistance.

We also recommend checking out our Support Center guide, How to Pay for Therapy Without Insurance Coverage, for additional resources about seeking therapy as a private-pay client.

Information about Out-of-Network Invoices

Appointment Invoice 

  • If your provider uses Alma billing, you will receive an invoice from noreply@helloalma.com after each session.
  • If you need an additional receipt, please reach out to your provider directly.

Payment Options for Out-of-Network Clients 

  • We recommend speaking with your provider about their preferred payment method. 
  • When you pay through Alma, you can use a credit, debit, or HSA card.
  • If your provider has enabled autopay, you can save a card on file to automatically submit payment when your provider submits an invoice.
  • If your provider uses Alma billing, you will receive a receipt via email, regardless of how you pay.

Monthly Superbill 

  • On the first of each month, you will receive a superbill to submit to your insurance for out-of-network session reimbursements. Your superbill will contain all the information necessary for submission. 
  • If you need another copy of your superbill sent out, please reach out to your provider directly. 
  • For assistance submitting to your insurance, please reach out to your provider directly. 
  • If your superbill is missing any information, please reach out to your provider directly.

For any additional questions or if you are in need of assistance, please email support@helloalma.com.

Was this article helpful?

2 out of 4 found this helpful

Have more questions? Submit a request