Learn the most common reasons your insurance may not cover a session, even with a provider in Alma's insurance program.
This article covers coverage gaps at the provider and session level. Even if Alma, as an organization, participates with your insurance plan, that does not mean every Alma provider participates with that plan too. If you want to know whether Alma participates with your plan at all, see Why Alma Doesn't Participate With Your Insurance Plan.
| Note: It is best to contact your insurance company directly to verify your specific benefits. The scenarios below cover the most common reasons for a coverage gap with a specific provider or session. |
The Plan on File is Not Your Primary Policy
If you have insurance through more than one company, your primary policy pays your claim first, as if it were your only coverage. Your secondary policy then covers some or all of the remaining cost.
For example, if you have a plan through your employer in addition to a spouse's or parent's plan, your employer plan is usually primary. Give your Alma provider your primary insurance plan. For a full breakdown of how this affects your eligibility with Alma specifically, see Why Alma Doesn't Participate With Your Insurance Plan.
Your Benefits Have Not Started, or They Have Ended
If you recently changed insurance plans, there may be a coverage gap between your previous plan ending and your new plan starting. Verify the start and end dates of your benefits with your insurance company to confirm your coverage details are accurate.
Your Provider Does Not Participate with Your Plan
Even if Alma, as an organization, participates with your insurance plan, that does not mean every Alma provider participates with that plan. If your provider does not participate with your plan, your provider does not have a contract with your plan's insurance company. For example, your provider may be credentialed with Aetna, but you are insured through Blue Cross Blue Shield.
Seeing a provider who does not participate with your plan typically costs more, since insurance companies cover a higher portion of visits with participating providers. In some cases, the cost difference is small. Confirm the cost of your sessions with both your insurance company and your provider. If you want other ways to lower your cost outside of insurance, see How to Pay for Therapy Without Insurance Coverage.
Still Need Help?
Contact us by selecting the Help button in the bottom right corner of the page.